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Study Finds Fear of Cancer Can Be Either a Facilitator or Deterrent to Getting Colorectal Cancer Screenings

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Key Points

  • Fearing cancer more than other diseases and worrying a lot about cancer increased intentions to get screened for colorectal cancer, but not actual clinical attendance.
  • Finding thoughts about cancer uncomfortable did not influence intention, but predicted lower colorectal cancer screening uptake.
  • Understanding the different aspects of cancer fear and their effects on the decision and action processes leading to screening participation might help in the design of effective public health messages.

People who worry a lot about cancer are more likely to want to get screened for colon cancer—perhaps due to a desire for reassurance—but having a more visceral negative response to thinking about cancer acted as a deterrent to actually getting screened, according to a British study by Vrinten et al. Understanding the different aspects of cancer fear and their effects on the decision and action processes leading to screening participation might help in the design of effective public health messages. The study is published in Cancer Epidemiology, Biomarkers & Prevention.

Study Methodology

The researchers recruited about 8,000 participants aged 55 to 64 years from the UK Flexible Sigmoidoscopy Screening Trial into their psychological substudy on cancer fear. Fifty-four percent of the participants were women, and 46% were men. The participants received a questionnaire that included three cancer fear items from a standard measure asking whether cancer was feared more than other diseases, cancer worry was experienced frequently, and thoughts about cancer caused discomfort.

Study Findings

Overall, 59% of the respondents were more afraid of cancer than of other diseases; 53% felt uncomfortable thinking about cancer; and 25% worried a lot about cancer. Of the 6,299 participants (82%) who responded they would “probably” or “definitely” take up the offer of colorectal cancer screening, 1,995 were randomly assigned to receive a screening invitation. Records from the clinics that performed the endoscopic screening showed that 71% went to their appointment.

According to the study abstract, fearing cancer more than other diseases (odds ratio [OR] = 2.32, P < .01) and worrying a lot about cancer (OR = 2.34, P < .01) increased intentions to attend screening, but not attendance. Finding thoughts about cancer uncomfortable did not influence intention, but predicted lower uptake (OR = 0.72, P < .01).

“The results of this study confirm that cancer fear can be a facilitator or a deterrent, depending on the specific aspect of fear,” concluded the researchers. “Having cancer as the greatest health fear or worrying a lot about it facilitated a positive intention to attend, while finding thoughts of cancer uncomfortable did not affect intention, but was a deterrent to actual attendance. Learning more about the make-up of cancer fear and more nuanced analysis of behavioral effects might help in the design of effective public health messages.” 

Charlotte Vrinten, MSc, of University College London, is the corresponding author of this study.

The study was funded by Cancer Research UK. The study authors declared no conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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