Community attitudes towards the early detection of cancer in Victoria, Australia

Impact of non-clinical community-based promotional campaigns on bowel cancer screening engagement: An integrative literature review

OBJECTIVE

This paper reviewed the relationship between non-clinical, client-oriented promotional campaigns to raise bowel cancer awareness and screening engagement.

METHOD

An integrative literature review using predefined search terms was conducted to summarise the accumulated knowledge. Data was analysed by coding and categorising, then synthesized through development of themes.

RESULTS

Eighteen of 116 studies met inclusion criteria. Promotional campaigns had varying impact on screening uptake for bowel cancer. Mass media was found to moderately increase screening, predominately amongst "worried well". Small media used in conjunction with other promotional activities, thus its effect on screening behaviours was unclear. One-on-one education was less effective and less feasible than group education in increasing intention to screen. Financial support was ineffective in increasing screening rates when compared to other promotional activities. Screening engagement increased because of special events and celebrity endorsement.

CONCLUSION

Non-clinical promotional campaigns did impact uptake of bowel cancer screening engagement. However, little is evident on the effect of single types of promotion and most research is based on clinician-directed campaigns.

PRACTICE IMPLICATIONS

Cancer awareness and screening promotions should be implemented at community and clinical level to maximize effectiveness. Such an approach will ensure promotional activities are targeting consumers, thus strengthening screening engagement.

The effect of cancer warning statements on alcohol consumption intentions

In response to increasing calls to introduce warning labels on alcoholic beverages, this study investigated the potential effectiveness of alcohol warning statements designed to increase awareness of the alcohol-cancer link. A national online survey was administered to a diverse sample of Australian adult drinkers (n = 1,680). Along with attitudinal, intentions and demographic items, the survey included an online simulation that exposed respondents to one of six cancer warning statements delivered across a range of situational contexts. Half of the statements made general reference to cancer and half mentioned specific forms of cancer. Respondents reported on the believability, convincingness and personal relevance of the warning statements. Pre- and post-exposure data were captured relating to respondents' alcohol consumption intentions. Of the six statements tested, Alcohol increases your risk of bowel cancer produced the highest scores across all outcome measures. All statements produced favorable changes in alcohol consumption intentions, including among high-risk drinkers. There is thus the potential for these and similar statements to be used as a suite of rotating warning messages located on alcoholic beverage labels and applied in various public education contexts.

Attitudes towards Lung Cancer Screening in an Australian High-Risk Population

Objectives. To determine whether persons at high risk of lung cancer would participate in lung cancer screening test if available in Australia and to elicit general attitudes towards cancer screening and factors that might affect participation in a screening program. Methods. We developed a 20-item written questionnaire, based on two published telephone interview scripts, addressing attitudes towards cancer screening, perceived risk of lung cancer, and willingness to be screened for lung cancer and to undertake surgery if lung cancer were detected. The questionnaire was given to 102 current and former smokers attending the respiratory clinic and pulmonary rehabilitation programmes. Results. We gained 90 eligible responses (M:F, 69:21). Mean [SD] age was 63 [11] and smoking history was 32 [21] pack years. 95% of subjects would participate in a lung cancer screening test, and 91% of these would consider surgery if lung cancer was detected. 44% of subjects considered that they were at risk of lung cancer. This was lower in ex-smokers than in current smokers. Conclusions. There is high willingness for lung cancer screening and surgical treatment. There is underrecognition of risk among ex-smokers. This misperception could be a barrier to a successful screening or case-finding programme in Australia.

Current state of medical-advice-seeking behaviour for symptoms of colorectal cancer: determinants of failure and delay in medical consultation

AIM

There are few data on the factors associated with healthcare-seeking behaviour for symptoms of colorectal cancer. This study describes the determinants of failure and delay in seeking medical advice for rectal bleeding and change in bowel habit.

METHOD

In total, 1592 persons (56-88 years) were randomly selected from the Hunter Community Study and mailed a questionnaire.

RESULTS

In all, 18% (60/332) of respondents experiencing rectal bleeding and 20% (39/195) reporting change in bowel habit had never consulted a doctor. The rate of delay (>1 month) for each symptom was 18% and 37%. The reasons for delay included the assumption that the symptoms were not serious or that they were benign. Triggers for seeking medical advice varied. Healthcare-seeking behaviour for rectal bleeding had not significantly improved compared with a previous community-based study.

CONCLUSION

The seriousness of symptoms, importance of early detection and prompt medical consultation must be articulated in health messages to at-risk persons.

Melanoma and its relationship with solarium use Health knowledge, attitudes and behaviour of young women

Despite growing evidence of a relationship between solarium use and melanoma development, few studies have examined knowledge, attitudes and behaviour towards solarium use among young women. Females aged 18—26 years attended one of six focus groups ( N = 27, seven solarium users and 20 non-users). Three specific themes were endorsed: (1) melanoma knowledge; (2) perceptions of melanoma risk and ways to encourage behaviour change; and (3) health promotion and government regulation. Many young women appear to lack knowledge about melanoma and its relationship with solarium use. Knowledge deficits are highlighted and implications for health prevention/promotion campaigns and future research are discussed.

'A matter of faith, not science': analysis of media coverage of prostate cancer screening in Australian news media 2003-2006

OBJECTIVE

Despite a near universal absence of evidence-based policies supporting population screening for prostate cancer, the prostate-specific antigen (PSA) test is aggressively promoted in the media as a life-saving form of screening. The objective of this study was to examine media coverage of prostate-cancer screening in Australia.

DESIGN

Frame analysis of all direct or attributed quotes about prostate cancer.

SETTING

Australian capital city newspapers (February 2003-December 2006) and Sydney television news (January 2003-December 2006).

MAIN OUTCOME MEASURES

Quotes regarding prostate cancer screening: n=436 in newspapers and television news.

RESULTS

Seven rhetorical frames were identified. 86% of all quotes framed prostate screening and its outcomes as desirable, associating PSA testing as being consonant with other early-detection cancer-control messages. Adverse surgical sequelae to screening were often minimized, scientific progress highlighted and gender equity appeals appropriated. Those questioning screening were vilified, with epidemiology being framed as an inferior form of knowledge than clinical experience.

CONCLUSIONS

Australian men are exposed to unbalanced and often non-evidence-based appeals to seek PSA testing. There is a disturbing lack of effort to redress this imbalance.