The study, published in Cancer Epidemiology, Biomarkers Prevention, looked at how different types of fear influenced colorectal cancer screening decisions in nearly eight thousand UK adults. Different experiences of fear were found to have different effects on people’s likeliness to get tested.
“Many people are afraid of getting cancer, but fear doesn’t have the same effect on everyone,” explains lead author Charlotte Vrinten, a research psychologist at the Cancer Research UK Health Behaviour Research Centre at UCL. “For some people, cancer fear motivates them to get checked up, for others, it puts them off from finding out whether they have cancer.
“No-one before has worked out why fear might have such opposite effects. In our study, instead of using a combined measure of cancer fear, as is often done, we distinguished different aspects of fear to see whether they had different effects on people’s decisions about cancer screening.”
People who worried a lot about cancer were more likely to want to get screened for colon cancer, but those who felt uncomfortable thinking about cancer were 12% less likely to attend screening.
“Twelve percent may not seem like a lot,” says Vrinten, “but given that tens of thousands of people are eligible for this type of screening, it means a big difference in the number of people actually attending. Our study also showed that cancer fear is still very common: more than half of our participants said they felt uncomfortable when thinking about cancer, and about a quarter worried a lot about cancer.
“Public campaigns often focus on increasing public fear about cancer, for example, by emphasizing how common cancer is or how deadly some types of cancer are. This might put some people off, rather than motivate them to get screened. Public information about endoscopic screening for colon cancer should help people understand that it can actually prevent colon cancer, so having the test can mean they have one less cancer to worry about.”
The study looked at nearly eight thousand participants between 55 and 64 years old from the UK Flexible Sigmoidoscopy trial. 82% responded that they would “probably” or “definitely” take up an offer of colorectal cancer screening. Overall, 59% of the respondents were more afraid of cancer than of other diseases, 53% felt uncomfortable thinking about cancer, and 25% worried a lot about cancer. Worriers were more likely to want to get screened: 89% said they would attend versus 79% of those who did not worry about cancer.
Nearly 2,000 participants were randomised to receive a screening invitation, and clinical records showed that 71% actually attended. 68% of those who felt uncomfortable thinking about cancer attended screening, compared with 77% of those who did not feel uncomfortable.