School of Psychology, Dublin City University, Ireland.
School of Public Health, University College Cork, Ireland.
Prev Med. 2021 Apr;145:106430. doi: 10.1016/j.ypmed.2021.106430. Epub 2021 Jan 19.
Although systematic colorectal cancer screening is efficacious, many programmes suffer from low uptake. Few behavioural or attitudinal factors have been identified as being associated with participation in colorectal cancer screening. We explored knowledge, beliefs about cancer, subjective health literacy, emotional attitudes to screening, and social influences among individuals invited to a population-based screening programme. Regression modelling of a cross-sectional survey of 2299 individuals (users and non-users) of a population-based Faecal Immunochemical Test (FIT) screening programme in Dublin was conducted. Questions were derived from previous theoretically-informed qualitative work and assessed using previously used and validated measures. The primary outcome variable was uptake status (User/Participation or Non-User/Non-participation); multivariable logistic regression was used to estimate the odds ratios (OR) for screening participation. Stronger fatalistic beliefs independently predicted lower uptake (OR = 0.94; 95% CI 0.90-0.98; P = 0.003). Those aged <65 who disagreed that "cancer can often be cured" also had lower uptake (OR = 0.43; 95% CI 0.22-0.82: P = 0.017). Agreement that the test was disgusting and tempting fate predicted lower uptake (OR = 0.16: 95% CI 0.10-0.27: p < 0.001), while the influence of a partner on decision to be screened was associated with higher uptake (OR = 1.32; 95% CI 1.15-1.50: P < 0.001). Negative cancer-related and screening-related beliefs and emotions are associated with non-participation in FIT (-based screening). Research is warranted to explore if these negative beliefs and emotions are modifiable and, if so, whether this would improve screening uptake. The association between the influence of a partner and screening participation present a challenge around improving uptake among those not in co-habiting relationships.
虽然系统的结直肠癌筛查是有效的，但许多项目的参与率都很低。只有少数行为或态度因素被认为与结直肠癌筛查的参与有关。我们探讨了在邀请参加基于人群的筛查计划的个体中，知识、对癌症的信念、主观健康素养、对筛查的情绪态度以及社会影响。对都柏林基于人群的粪便免疫化学试验（FIT）筛查计划的 2299 名个体（使用者和非使用者）进行了横断面调查的回归建模。问题来源于以前理论上的定性研究，并使用以前使用和验证过的方法进行评估。主要结果变量是参与筛查的状态（使用者/参与或非使用者/不参与）；多变量逻辑回归用于估计筛查参与的优势比（OR）。更强烈的宿命论信念独立预测了较低的参与率（OR=0.94；95%CI 0.90-0.98；P=0.003）。年龄<65 岁且不同意“癌症通常可以治愈”的人，参与率也较低（OR=0.43；95%CI 0.22-0.82；P=0.017）。同意测试令人作呕和命中注定会预测较低的参与率（OR=0.16；95%CI 0.10-0.27；p<0.001），而伴侣对决定筛查的影响与较高的参与率相关（OR=1.32；95%CI 1.15-1.50；P<0.001）。与癌症相关和与筛查相关的负面信念和情绪与不参与 FIT（基于筛查）有关。有必要进行研究，以探讨这些负面信念和情绪是否可以改变，如果可以，是否可以提高筛查的参与率。伴侣的影响与筛查参与之间的关联，对改善非同居关系人群的参与率提出了挑战。
