Cancer Communication and Screening Group, Research Department of Behavioural Science and Health, University College London, Gower Street, London, UK.
J Med Screen. 2019 Mar;26(1):3-10. doi: 10.1177/0969141318796258. Epub 2018 Sep 24.
Some degree of general worry about cancer may facilitate screening participation, but specific worries about the potential consequences (e.g. treatment, death) may act as deterrents. No studies have examined these associations in the same sample. We assessed associations between general versus specific cancer worries and cancer screening participation.
In 2016, a population-based cross-sectional survey of adults living in England was carried out. This paper reports analyses of a subsample (n = 1694). Measures included (i) frequency of general cancer worry, (ii) specific worries about the emotional and physical consequences of a cancer diagnosis, and (iii) specific worries about the social consequences of a cancer diagnosis. Logistic regression analyses examined their association with self-reported screening uptake among participants eligible for cervical (n = 671), breast (n = 323), and colorectal (n = 368) cancer screening.
Frequency of general cancer worry was not associated with screening participation. Specific worry about the emotional and physical consequences increased the odds of participants reporting regular uptake of colorectal screening (OR 1.41, 95% CI 1.04-1.90). Specific worry about the social consequences of diagnosis was negatively associated with regular attendance for cervical and breast screening in unadjusted analyses only. In adjusted models, the associations were no longer statistically significant for cervical (OR 0.82, 95% CI 0.65-1.03) or breast (OR 0.69, 95% CI 0.45-1.04) screening.
Specific worries about cancer may be differentially associated with participation across screening programmes. Further research is needed, as interventions to optimise informed participation may be improved if the specific worries associated with low participation in each programme are understood.
对癌症的某种程度的普遍担忧可能有助于促进筛查参与，但对潜在后果（例如治疗、死亡）的具体担忧可能会成为阻碍。没有研究在同一样本中检查过这些关联。我们评估了一般癌症担忧与癌症筛查参与之间的关联与特定的癌症担忧。
2016 年，对居住在英格兰的成年人进行了一项基于人群的横断面调查。本文报告了对亚样本（n=1694）的分析。测量包括（i）一般癌症担忧的频率，（ii）对癌症诊断的情绪和身体后果的具体担忧，以及（iii）对癌症诊断的社会后果的具体担忧。逻辑回归分析检查了它们与有资格进行宫颈（n=671）、乳房（n=323）和结直肠（n=368）癌症筛查的参与者报告的筛查参与率之间的关系。
一般癌症担忧的频率与筛查参与无关。对诊断的情绪和身体后果的具体担忧增加了参与者报告定期接受结直肠筛查的几率（OR 1.41，95%CI 1.04-1.90）。仅在未调整的分析中，对诊断的社会后果的具体担忧与定期进行宫颈和乳房筛查呈负相关。在调整后的模型中，与宫颈（OR 0.82，95%CI 0.65-1.03）或乳房（OR 0.69，95%CI 0.45-1.04）筛查相比，关联不再具有统计学意义。
对癌症的具体担忧可能与参与不同的筛查计划相关。需要进一步研究，因为如果理解了与每个计划低参与率相关的具体担忧，那么优化知情参与的干预措施可能会得到改善。
