Vrinten Charlotte, Waller Jo, von Wagner Christian, Wardle Jane
Epidemiology and Public Health, University College London, London, United Kingdom.
Cancer Epidemiol Biomarkers Prev. 2015 Feb;24(2):400-5. doi: 10.1158/1055-9965.EPI-14-0967.
Cancer fear has been associated with higher and lower screening uptake across different studies, possibly because different aspects of cancer fear have different effects on intentions versus behavior. The present study examined associations of three aspects of cancer fear with intention and uptake of endoscopic screening for colorectal cancer.
A subsample of UK Flexible Sigmoidoscopy (FS) Trial participants received a baseline questionnaire that included three cancer fear items from a standard measure asking if: (i) cancer was feared more than other diseases, (ii) cancer worry was experienced frequently, and (iii) thoughts about cancer caused discomfort. Screening intention was assessed by asking participants whether, if invited, they would accept an invitation for FS screening. Positive responders were randomized to be invited or not in a 1:2 ratio. The behavioral outcome was clinic-recorded uptake. Control variables were age, gender, ethnicity, education, and marital status.
The questionnaire return rate was 60% (7,971/13,351). The majority (82%) intended to attend screening; 1,920 were randomized to receive an invitation, and 71% attended. Fearing cancer more than other diseases (OR = 2.32, P < 0.01) and worrying a lot about cancer (OR = 2.34, P < 0.01) increased intentions to attend screening, but not uptake. Finding thoughts about cancer uncomfortable did not influence intention, but predicted lower uptake (OR = 0.72, P < 0.01).
Different aspects of cancer fear have different effects on the decision and action processes leading to screening participation.
Knowledge of the different behavioral effects of cancer fear may aid the design of effective public health messages.
在不同研究中，对癌症的恐惧与结肠镜检查筛查率的高低均有关联，这可能是因为癌症恐惧的不同方面对意图和行为有着不同影响。本研究探讨了癌症恐惧的三个方面与结直肠癌内镜筛查的意图和接受情况之间的关联。
英国柔性乙状结肠镜检查（FS）试验参与者的一个子样本收到了一份基线调查问卷，其中包括来自一项标准测量的三个癌症恐惧项目，询问：（i）是否比其他疾病更害怕癌症，（ii）是否经常担心患癌，以及（iii）对癌症的想法是否会引起不适。通过询问参与者如果收到邀请是否会接受FS筛查来评估筛查意图。积极回应者按1:2的比例随机分为是否被邀请组。行为结果为临床记录的接受情况。控制变量包括年龄、性别、种族、教育程度和婚姻状况。
问卷回复率为60%（7971/13351）。大多数人（82%）打算参加筛查；1920人被随机分配接受邀请，71%的人参加了筛查。比起其他疾病更害怕癌症（比值比=2.32，P<0.01）以及非常担心患癌（比值比=2.34，P<0.01）会增加参加筛查的意图，但不会增加接受率。觉得对癌症的想法令人不适不会影响意图，但预示着接受率较低（比值比=0.72，P<0.01）。
癌症恐惧的不同方面对导致参与筛查的决策和行动过程有不同影响。
了解癌症恐惧的不同行为影响可能有助于设计有效的公共卫生信息。
