Abstract
Cancer screening could be an opportunity to deliver cancer prevention advice, but it is not known how such information would be received. We explored willingness to receive lifestyle advice in the context of the English National Health Service cervical, breast, and bowel (FS; flexible sigmoidoscopy) screening programmes. A population-based survey was conducted in 2016 to collect nationally representative data on willingness to receive lifestyle advice across cervical (n = 768), breast (n = 420) and FS (n = 308) screening programmes. Additional items assessed the impact of lifestyle advice on screening attendance, preference for receiving advice in the event of an abnormal screening result, and timing of advice. Most respondents were willing to receive lifestyle advice around the time of cancer screening (cervical 78.9%, breast 79.4%, FS 81.8%), and if their results were abnormal (cervical 86.3%, breast 83.0%, FS 85.1%). A small proportion indicated it may discourage future attendance (cervical 4.9%, breast 7.0%, FS 8.8%). Most preferred information to be delivered at the screening appointment (cervical 69.8%, breast 72.6%, FS 70.7%). There were no associations between sociodemographic characteristics and willingness to receive lifestyle advice at breast screening. For those intending to attend cervical screening, non-White ethnicity and higher education were associated with increased willingness to receive lifestyle advice. Women were more likely to be willing to receive advice at FS screening than men. Providing lifestyle advice at cancer screening is likely to be acceptable to the general population. The optimal approach for delivery needs careful consideration to minimise potential negative effects on screening attendance.
Highlights
In 2014 there were 350,000 cancer diagnoses in the UK, and by 2035 annual diagnoses are expected to exceed 500,000 (Cancer Research, 2016; Smittenaar et al, 2016)
The mean age of the analytic sample was Ethnicity and educational attainment were associated with willingness to receive advice at cervical screening (Table 3)
Non-white participants had greater odds of being willing to receive lifestyle advice (89.8% vs 77.0%; OR 2.39, 95% CI 1.16–4.93)
Summary
In 2014 there were 350,000 cancer diagnoses in the UK, and by 2035 annual diagnoses are expected to exceed 500,000 (Cancer Research, 2016; Smittenaar et al, 2016). Tobacco use is the single greatest cancer risk factor, the contribution of risk factors varies by cancer type. The greatest risk factors for colorectal cancer include overweight, dietary factors, alcohol and tobacco use (Brown et al, 2018). Cancer screening has been described as a ‘teachable moment’, providing an opportunity to deliver cancer prevention advice and interventions (Senore et al, 2012). Providing lifestyle advice alongside cancer screening is consistent with English policy to ‘Make Every Contact Count’ by utilising interactions with the public to support health and wellbeing (Public Health England, 2016a). There is little evidence that cancer prevention advice is delivered routinely alongside cancer screening in the UK (Anderson et al, 2013)
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