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Fletcher S, Goodwin BC. Testing outside of the National Bowel and Breast Cancer Screening Programs in Queensland, Australia. J Med Screen 2024:9691413241256595. [PMID: 38797978 DOI: 10.1177/09691413241256595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Setting: Bowel and breast cancer testing outside of the national programs is not routinely recorded in Australia, limiting our ability to monitor and estimate true screening coverage. Objective: This study makes preliminary estimates of the proportion of eligible participants who test for bowel and breast cancer outside of national programs using a large convenience sample of 31,065 cancer risk calculator respondents. Methods: Logistic regression was applied to assess difference in cancer testing both within and outside respective programs between demographic groups. Results: Almost one-third (9456 respondents) were aged between 50 and 74 years and eligible to participate in the National Bowel Cancer Screening Program (NBCSP) with 8073 female respondents additionally qualifying for the national BreastScreen program. Out of 4166 respondents who reported not to participate in the NBCSP, over 2000 (48.4%) reported 'screening' outside the NBCSP. For breast cancer the rate of self-reported screening outside BreastScreen was even higher, with 2442 (73.8%) of 3308 respondents who did not participate in BreastScreen reporting undergoing testing elsewhere. Interestingly, outer regional or remote residence was associated with lower participation within the NBCSP (OR = 0.92; p = 0.05) and higher testing outside of BreastScreen (OR = 1.21; p < 0.05) screening programs. Conclusion: Findings provide preliminary support for the need to better understand the volume of cancer testing taking place outside the national programs and to address reporting gaps within the health system.
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Affiliation(s)
- Sabine Fletcher
- Health Systems & Behavioural Research, Cancer Council Queensland, Fortitude Valley, QLD, Australia
| | - Belinda C Goodwin
- Health Systems & Behavioural Research, Cancer Council Queensland, Fortitude Valley, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
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2
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McDonnell D, Afolabi PR, Wilding S, Griffiths GO, Swann JR, Byrne CD, Hamady ZZ. Utilising Pancreatic Exocrine Insufficiency in the Detection of Resectable Pancreatic Ductal Adenocarcinoma. Cancers (Basel) 2023; 15:5756. [PMID: 38136302 PMCID: PMC10741412 DOI: 10.3390/cancers15245756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed late, leading to a high mortality rate. Early detection facilitates better treatment options. The aim of this UK-based case-control study was to determine whether two validated tests for pancreatic exocrine insufficiency (PEI), namely, the 13C-mixed triglyceride breath test (13C-MTGBT) and a faecal elastase (FE-1) test, can discriminate between patients with resectable PDAC versus healthy volunteers (HVs) along with a comparison group with chronic pancreatitis (CP). Discrimination between disease states and HVs was tested with receiver operator characteristic (ROC) curves. In total, 59 participants (23 PDAC (16 men), 24 HVs (13 men) and 12 CP (10 men)) were recruited, with a similar age in each population, and a combined median (IQR) age of 66 (57-71). The areas under the ROC curve for discriminating between PDAC and HVs were 0.83 (95% CI: 0.70-0.96) for the 13C-MTGBT, and 0.85 (95% CI: 0.75-0.95) for the FE-1 test. These were similar to CP vs. HV. In conclusion, PEI occurs in resectable PDAC to a similar extent as in CP; further large-scale, prospective studies using these tests in the primary care setting on high-risk groups are warranted.
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Affiliation(s)
- Declan McDonnell
- Human Development & Health, University of Southampton, Southampton SO16 6YD, UK; (P.R.A.); (Z.Z.H.)
- University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Paul R. Afolabi
- Human Development & Health, University of Southampton, Southampton SO16 6YD, UK; (P.R.A.); (Z.Z.H.)
| | - Sam Wilding
- Cancer Research UK Southampton Clinical Trials Unit, University of Southampton, Southampton SO17 1BJ, UK
| | - Gareth O. Griffiths
- University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Cancer Research UK Southampton Clinical Trials Unit, University of Southampton, Southampton SO17 1BJ, UK
| | - Jonathan R. Swann
- Human Development & Health, University of Southampton, Southampton SO16 6YD, UK; (P.R.A.); (Z.Z.H.)
| | - Christopher D. Byrne
- Human Development & Health, University of Southampton, Southampton SO16 6YD, UK; (P.R.A.); (Z.Z.H.)
- University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Zaed Z. Hamady
- Human Development & Health, University of Southampton, Southampton SO16 6YD, UK; (P.R.A.); (Z.Z.H.)
- University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
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3
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Goodwin B, Anderson L, Collins K, Sanjida S, Riba M, Singh GK, Campbell KM, Green H, Ishaque S, Kwok A, Opozda MJ, Pearn A, Shaw J, Sansom-Daly UM, Tsirgiotis JM, Janda M, Grech L. Anticipatory anxiety and participation in cancer screening. A systematic review. Psychooncology 2023; 32:1773-1786. [PMID: 37929985 DOI: 10.1002/pon.6238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES To synthesize current evidence on the association between anticipatory anxiety, defined as apprehension-specific negative affect that may be experienced when exposed to potential threat or uncertainty, and cancer screening to better inform strategies to maximize participation rates. METHODS Searches related to cancer screening and anxiety were conducted in seven electronic databases (APA PsycINFO, Scopus, Web of Science, Embase, Cochrane Library, PubMed, CINAHL), with potentially eligible papers screened in Covidence. Data extraction was conducted independently by multiple authors. Barriers to cancer screening for any type of cancer and relationships tested between anticipatory anxiety and cancer screening and intention were categorized and compared according to the form and target of anxiety and cancer types. RESULTS A total of 74 articles (nparticipants = 119,990) were included, reporting 103 relationships tested between anticipatory anxiety and cancer screening and 13 instances where anticipatory anxiety was reported as a barrier to screening. Anticipatory anxiety related to a possible cancer diagnosis was often associated with increased screening, while general anxiety showed no consistent relationship. Negative relationships were often found between anxiety about the screening procedure and cancer screening. CONCLUSION Anticipatory anxiety about a cancer diagnosis may promote screening participation, whereas a fear of the screening procedure could be a barrier. Public health messaging and primary prevention practitioners should acknowledge the appropriate risk of cancer, while engendering screening confidence and highlighting the safety and comfort of screening tests.
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Affiliation(s)
- Belinda Goodwin
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Laura Anderson
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Katelyn Collins
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Saira Sanjida
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Marcos Riba
- The University of Queensland, Saint Lucia, Queensland, Australia
| | - Gursharan K Singh
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- Cancer and Palliative Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kimberley M Campbell
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Heather Green
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Sana Ishaque
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Alastair Kwok
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Department of Oncology, Monash Health, Clayton, Victoria, Australia
| | - Melissa J Opozda
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
| | - Amy Pearn
- The Gene Council, North Perth, Washington, Australia
| | - Joanne Shaw
- Psycho-oncology Co-operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ursula M Sansom-Daly
- Psycho-oncology Co-operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW Sydney, Kensington, New South Wales, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Joanna M Tsirgiotis
- Sydney Youth Cancer Centre, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Monika Janda
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Grech
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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4
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Myers L, Goodwin B, Viljoen B, Roe CG, Ireland MJ. The Barriers to Bowel Cancer Screening Scale: Examining Structural Validity, Measurement Invariance, and Criterion Validity. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:E190-E197. [PMID: 37097206 DOI: 10.1097/phh.0000000000001751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE The success of national cancer screening programs, such as the National Bowel Cancer Screening Program (NBCSP) in Australia, depends on public participation, which is currently an alarming 43.5% for the NBCSP. Understanding the barriers that impede screening participation requires valid measurement instruments. This study aims to cross-validate such an instrument with a new, large, and varied sample, as well as assess measurement invariance across subsamples at a greatest risk of nonparticipation (ie, testing whether the scale functions in similar ways across groups). DESIGN, SETTING, AND PARTICIPANTS A cross-sectional sample of 1158 participants from the target screening population (50-74 years) provided demographic information, responses to the Barriers to Home Bowel Screening (BB-CanS) scale, and information on their previous screening participation. RESULTS Both the full and the brief versions of the BB-CanS scale showed good model fit for the full sample and for gender and age subsamples. Despite the inter-factor correlations being high, the unidimensional and bi-factor models exhibited poorer fit. Improvement in fit was observed with scale refinement involving the removal of 7 items. All versions of the BB-CanS scale were invariant across gender and age subsamples. Age and gender differences emerged across several barriers and variance in all 4 barriers significantly predicted prior screening participation. CONCLUSION The BB-CanS scale is a valid measure of 4 highly correlated barriers to home bowel cancer screening: disgust relating to screening, avoidance of test outcomes, practical difficulty (or challenges), and the need for a sense of greater autonomy. All versions of the instrument measure the equivalent construct across age and gender groups. Observed differences in barriers across at-risk groups provide targets for future intervention.
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Affiliation(s)
- Larry Myers
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich Queensland, Australia (Drs Myers and Ireland and Ms Roe); Cancer Council Queensland, Spring Hill, Queensland, Australia (Drs Myers and Goodwin and Ms Viljoen); Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia (Ms Viljoen and Dr Goodwin); and School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia (Ms Viljoen)
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5
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Dasgupta P, Cameron JK, Goodwin B, Cramb SM, Mengersen K, Aitken JF, Baade PD. Geographical and spatial variations in bowel cancer screening participation, Australia, 2015-2020. PLoS One 2023; 18:e0288992. [PMID: 37471422 PMCID: PMC10358922 DOI: 10.1371/journal.pone.0288992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/09/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Participation in bowel cancer screening programs remains poor in many countries. Knowledge of geographical variation in participation rates may help design targeted interventions to improve uptake. This study describes small-area and broad geographical patterns in bowel screening participation in Australia between 2015-2020. METHODS Publicly available population-level participation data for Australia's National Bowel Cancer Screening Program (NBCSP) were modelled using generalized linear models to quantify screening patterns by remoteness and area-level disadvantage. Bayesian spatial models were used to obtain smoothed estimates of participation across 2,247 small areas during 2019-2020 compared to the national average, and during 2015-2016 and 2017-2018 for comparison. Spatial heterogeneity was assessed using the maximized excess events test. RESULTS Overall, screening participation rates was around 44% over the three time-periods. Participation was consistently lower in remote or disadvantaged areas, although heterogeneity was evident within these broad categories. There was strong evidence of spatial differences in participation over all three periods, with little change in patterns between time periods. If the spatial variation was reduced (so low participation areas were increased to the 80th centile), an extra 250,000 screens (4% of total) would have been conducted during 2019-2020. CONCLUSIONS Despite having a well-structured evidence-based government funded national bowel cancer screening program, the substantial spatial variation in participation rates highlights the importance of accounting for the unique characteristics of specific geographical regions and their inhabitants. Identifying the reasons for geographical disparities could inform interventions to achieve more equitable access and a higher overall bowel screening uptake.
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Affiliation(s)
- Paramita Dasgupta
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Jessica K. Cameron
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Belinda Goodwin
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
- Centre for Heath Research, University of Southern Queensland, Springfield, Queensland, Australia
| | - Susanna M. Cramb
- Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kerrie Mengersen
- Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joanne F. Aitken
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Peter D. Baade
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
- Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
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6
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Myers L, Ireland MJ, Viljoen B, Goodwin B. Evaluating changes to home bowel cancer screening kits: an end-user perspective study. Cancer Causes Control 2023; 34:583-594. [PMID: 37081155 DOI: 10.1007/s10552-023-01695-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE Many people do not participate in mail-out bowel cancer screening programs due to difficulties using the screening kit. The current study investigated the ways the screening kit could be modified to improve usability. METHODS 1,109 people evaluated 15 different screening kit modifications. Participants reported on how these kit modifications would affect their screening barriers, their future screening intentions, and how much they would recommend that the modification is made to the current screening kit used the program. All responses were given via an online survey conducted between April and December of 2021. RESULTS Seventeen percent of previous NBCSP non-participators indicated that a one-sample test would increase their intention to participate. Recommendation ratings demonstrated higher levels of support for modifications that included providing a barcode naming label (M = 9.06, 95% CI [8.81, 9.31]), having a larger diameter opening of the collection tube (M = 8.42, 95% CI [8.10, 8.74]), and highlighting the expiry date on the kit packaging (M = 8.59, 95% CI [8.29, 8.89]). There were lower levels of support for modifications that reduced the size of the packaging the kit is sent in (M = 6.47, 95% CI [6.09, 6.85]), removed branding from kit packaging (M = 5.98, 95% CI [5.57, 6.39]), and removed the information booklet that comes with the screening kit (M = 5.25, 95% CI [4.78, 5.72]). CONCLUSION These findings highlight multiple ways in which bowel cancer screening kits can be changed to increase usability for invitees of national bowel cancer screening programs. Findings have implications for all screening programs that use immunochemical-based bowel cancer screening kits.
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Affiliation(s)
- L Myers
- Cancer Council Queensland, 553 Gregory Terrace, Fortitude Valley, Brisbane, QLD, 4006, Australia.
- School of Psychology and Well-Being, University of Southern Queensland, Springfield, Australia.
| | - M J Ireland
- School of Psychology and Well-Being, University of Southern Queensland, Springfield, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Australia
| | - B Viljoen
- Cancer Council Queensland, 553 Gregory Terrace, Fortitude Valley, Brisbane, QLD, 4006, Australia
- School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Australia
| | - B Goodwin
- Cancer Council Queensland, 553 Gregory Terrace, Fortitude Valley, Brisbane, QLD, 4006, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Australia
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7
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Anderson LE, Ireland MJ, Myers L, Avenell C, Connaughton T, Goodwin BC. Psychological distress and bowel cancer screening participation. Psychooncology 2023; 32:229-236. [PMID: 36434675 DOI: 10.1002/pon.6072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To better understand barriers to participation in mail-out bowel cancer screening programs, two survey studies tested the relationship between psychological distress and self-reported bowel cancer screening. METHODS First, a nationally representative sample of Australians N = 5421 completed measures of bowel cancer screening and psychological distress (using the Kessler Psychological Distress Scale; K10). Second, N = 479 completed a survey measuring participation in the National Bowel Cancer Screening Program (NBCSP) and psychological distress using the Depression, Anxiety and Stress Scale. In both studies, logistic regressions were conducted to test relationships between psychological distress and self-reported screening participation. RESULTS Study one found that psychological distress had a significant quadratic effect on having ever screened for bowel cancer, where screening rates were similar for those with low, moderate, or high levels of distress, but were lower for those with very high levels of distress. In study two, depression scores had a negative linear relationship with NBCSP participation (higher depression levels were associated with lower screening participation), and anxiety had a quadratic effect whereby NBCSP participation rates were higher with increasing levels of anxiety except in the severe category, where participation was significantly lower. CONCLUSIONS Findings indicate that psychological distress has a complex relationship with screening, and those with extreme levels of distress consistently show lower participation rates. Special efforts to encourage screening may be required for those experiencing extreme psychological distress and mental health disorders.
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Affiliation(s)
| | - Michael J Ireland
- Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia.,School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Larry Myers
- Cancer Council Queensland, Brisbane, Queensland, Australia.,School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Claire Avenell
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Tanaya Connaughton
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Belinda C Goodwin
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, QLD, Australia
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8
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Bongaerts THG, Büchner FL, Crone MR, van Exel J, Guicherit OR, Numans ME, Nierkens V. Perspectives on cancer screening participation in a highly urbanized region: a Q-methodology study in The Hague, the Netherlands. BMC Public Health 2022; 22:1925. [PMID: 36243684 PMCID: PMC9571478 DOI: 10.1186/s12889-022-14312-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Netherlands hosts, as many other European countries, three population-based cancer screening programmes (CSPs). The overall uptake among these CSPs is high, but has decreased over recent years. Especially in highly urbanized regions the uptake rates tend to fall below the minimal effective rate of 70% set by the World Health Organization. Understanding the reasons underlying the decision of citizens to partake in a CPS are essential in order to optimize the current screening participation rates. The aim of this study was to explore the various perspectives concerning cancer screening among inhabitants of The Hague, a highly urbanized region of the Netherlands. METHODS A Q-methodology study was conducted to provide insight in the prevailing perspectives on partaking in CSPs. All respondents were inhabitants of the city of The Hague, the Netherlands. In an online application they ranked a set of 31 statements, based on the current available literature and clustered by the Integrated Change model, into a 9-column forced ranking grid according to level of agreement, followed by a short survey. Respondents were asked to participate in a subsequent interview to explain their ranking. By-person factor analysis was used to identify distinct perspectives, which were interpreted using data from the rankings and interviews. RESULTS Three distinct perspectives were identified: 1). "Positive about participation", 2). "Thoughtful about participation", and 3). "Fear drives participation". These perspectives provide insight into how potential respondents, living in an urbanized region in the Netherlands, decide upon partaking in CSPs. CONCLUSIONS Since CSPs will only be effective when participation rates are sufficiently high, it is essential to have insight into the different perspectives among potential respondents concerning partaking in a CSP. This study adds new insights concerning these perspectives and suggests several ideas for future optimization of the CSPs.
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Affiliation(s)
- Thomas H G Bongaerts
- Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands. .,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Frederike L Büchner
- Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Matty R Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Erasmus Centre for Health Economics Research, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Onno R Guicherit
- University Cancer Center Leiden - The Hague, at Haaglanden Medical Center, The Hague, The Netherlands
| | - Mattijs E Numans
- Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Vera Nierkens
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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9
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Kotzur M, Macdonald S, O'Carroll RE, O'Connor RC, Irvine A, Steele RJC, Robb KA. What are common barriers and helpful solutions to colorectal cancer screening? A cross-sectional survey to develop intervention content for a planning support tool. BMJ Open 2022; 12:e062738. [PMID: 36691140 PMCID: PMC9445780 DOI: 10.1136/bmjopen-2022-062738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/05/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Colorectal screening using faecal immunochemical tests (FITs) can save lives if the people invited participate. In Scotland, most people intend to complete a FIT but this is not reflected in uptake rates. Planning interventions can bridge this intention-behaviour gap. To develop a tool supporting people willing to do colorectal screening with planning to complete a FIT, this study aimed to identify frequently experienced barriers and solutions to these barriers. DESIGN This is a cross-sectional study. SETTING Participants were recruited through the Scottish Bowel Screening Programme to complete a mailed questionnaire. PARTICIPANTS The study included 2387 participants who had completed a FIT (mean age 65 years, 40% female) and 359 participants who had not completed a FIT but were inclined to do so (mean age 63 years, 39% female). OUTCOME MEASURES The questionnaire assessed frequency of endorsement of colorectal screening barriers and solutions. RESULTS Participants who had not completed a FIT endorsed significantly more barriers than those who had completed a FIT, when demographic, health and behavioural covariates were held constant (F(1,2053)=13.40, p<0.001, partial η2=0.01). Participants who completed a FIT endorsed significantly more solutions than those who did not (U=301 585.50, z=-3.21, p<0.001, r=0.06). This difference became insignificant when covariates were controlled. Participants agreed on the most common barriers and solutions regardless of screening history. Barriers included procrastination, forgetting, fear of the test result, screening anxiety, disgust and low self-efficacy. Solutions included hand-washing, doing the FIT in private, reading the FIT instructions, benefit of early detection, feelings of responsibility, high self-efficacy and seeing oneself as a person who looks after one's health. CONCLUSION This survey identified six barriers and seven solutions as key content to include in the development of a planning tool for colorectal screening using the FIT. Participatory research is required to codesign an engaging and accessible planning tool.
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Affiliation(s)
- Marie Kotzur
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Sara Macdonald
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Rory C O'Connor
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | | | | | - Kathryn A Robb
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
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10
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Goodwin BC, Myers L, McKenna KN, Anderson LE, Ireland MJ. The role of need for control and self-reliance in gender and age differences in bowel cancer screening participation. Psychooncology 2022; 31:1988-1996. [PMID: 35726402 DOI: 10.1002/pon.5979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/23/2022] [Accepted: 06/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine the relationships between need for control and self-reliance and barriers to bowel cancer screening to better understand the reasons for lower bowel cancer screening adherence in males and younger individuals. METHODS Participants (n = 506) aged between 54 and 75 years old completed an online survey measuring demographic information, the four-factor Barriers to Home Bowel Cancer Screening Scale (BB-CanS) and a measure of Need for Control and Self-Reliance (NCSR). Model fit statistics were compared for seven path models testing the relationships between NCSR and BB-CanS factors and the moderating and mediating effects of age and gender. RESULTS Models where age and gender were included as moderators showed the best fit. When compared to females and those under 60 years of age, stronger positive associations between NCSR and BB-CanS factors were evident among males (βavoidance = 0.539, p < 0.001); βdisgust = 0.558, p < 0.001; βdifficulty = 0.489, p < 0.001; βautonomy = 0.619, p = 0.002) and those over 60 years of age (βavoidance = 0.400, p < 0.001); βdisgust = 0.462, p < 0.001; βdifficulty = 0.447, p < 0.001; βautonomy = 0.378, p < 0.001. CONCLUSIONS When encouraging males and people aged 60 years and over to participate in bowel cancer screening, public health messages may benefit from conveying preventative health behaviour and cancer screening participation as actions that reflect self-control and self-reliance.
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Affiliation(s)
- Belinda C Goodwin
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia
| | - Larry Myers
- Cancer Council Queensland, Brisbane, Queensland, Australia.,School of Psychology and Well-Being, University of Southern Queensland, Springfield, Australia
| | - Kirsten N McKenna
- School of Psychology and Well-Being, University of Southern Queensland, Springfield, Australia
| | | | - Michael J Ireland
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Psychology and Well-Being, University of Southern Queensland, Springfield, Australia
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Myers L, Goodwin BC, Ireland M, March S, Aitken J. Mail-out bowel cancer screening: Identifying the behavioural stumbling blocks. Psychooncology 2021; 31:816-823. [PMID: 34967054 DOI: 10.1002/pon.5866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/22/2021] [Accepted: 12/14/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To describe the actions taken by recipients of mail-out faecal occult blood test (FOBT) kits and to identify the points at which progress towards kit completion typically stops. Differences according to gender, age, and screening intention were also examined. METHODS 1599 people completed an online survey identifying the actions they took upon receiving an FOBT kit. Latent class analysis was conducted to identify latent subgroups of participants that reported similar actions. Differences between gender, age, and intention status were assessed using non-invariance testing. RESULTS Four latent subgroups of FOBT invitees were identified: those who complete and return their FOBT kit ('completers'); those who bring the kit into their house but go no further ('ignorers'); those who open the package and read the bowel cancer information materials but go no further ('readers'); and those who read the instructions but do not place the kit near the toilet and do not complete their FOBT kit ('leavers'). Non-completers who intended to use the kit were most likely to be in the 'leavers' class, while those who had no intention were most likely to be in the 'readers' class. CONCLUSIONS Distinct subgroups of non-responders exist among bowel cancer screening invitees, suggesting different behaviour change interventions are needed to facilitate participation. Some invitees, especially those with high participatory intention, are likely to benefit from prompts to take the kit into the toilet, while others, with little participatory intention, often read the invitation materials presenting an opportunity to intervene with health messages.
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Affiliation(s)
- Larry Myers
- Cancer Council Queensland, Brisbane, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield, Australia
| | - Belinda C Goodwin
- Cancer Council Queensland, Brisbane, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia
| | - Michael Ireland
- Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield, Australia
| | - Sonja March
- Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield, Australia
| | - Joanne Aitken
- Cancer Council Queensland, Brisbane, Australia.,Centre for Health Research, University of Southern Queensland, Springfield, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,School of Public Health, The University of Queensland, Herston, Australia
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