Abstract
BackgroundDespite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low. People do not always act rationally, and investigating emotions may offer insight into the avoidance of screening. The current work assessed whether fear, embarrassment, and disgust predicted colorectal cancer screening avoidance.MethodsA community sample (N = 306) aged 45+ completed a questionnaire assessing colorectal cancer screening history and the extent that perceptions of cancer risk, colorectal cancer knowledge, doctor discussions, and a specifically developed scale, the Emotional Barriers to Bowel Screening (EBBS), were associated with previous screening behaviours and anticipated bowel health decision-making.ResultsStep-wise logistic regression models revealed that a decision to delay seeking healthcare in the hypothetical presence of bowel symptoms was less likely in people who had discussed risk with their doctor, whereas greater colorectal cancer knowledge and greater fear of a negative outcome predicted greater likelihood of delay. Having previously provided a faecal sample was predicted by discussions about risk with a doctor, older age, and greater embarrassment, whereas perceptions of lower risk predicted a lower likelihood. Likewise, greater insertion disgust predicted a lower likelihood of having had an invasive bowel screening test in the previous 5 years.ConclusionsAlongside medical and demographic factors, fear, embarrassment and disgust are worthy of consideration in colorectal cancer screening. Understanding how specific emotions impact screening decisions and behaviour is an important direction for future work and has potential to inform screening development and communications in bowel health.
Highlights
Despite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low
A parallel line of study has evaluated how emotions-based research may increase understanding of why people reject medical investigations they ought to attend [9]. We continue in this endeavour, presenting a report investigating possible emotional barriers to colorectal cancer (CRC) screening where, despite the benefits of early detection [10], screening rates are low
Our findings extend previous work that identified the role of faecal disgust as a barrier to bowel screening [31] by introducing the possibility that specific emotional responses might impact screening behaviours in different ways, and that the source of emotion is important
Summary
Despite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low. People do not always act rationally, and investigating emotions may offer insight into the avoidance of screening. The current work assessed whether fear, embarrassment, and disgust predicted colorectal cancer screening avoidance. Many organised population-based screening programmes have been implemented or are being progressively rolled out across regions [3]. Reynolds et al BMC Cancer (2018) 18:518 established benefits, even when screenings are free and accessible, many people continue to avoid them [7]. We continue in this endeavour, presenting a report investigating possible emotional (fear, embarrassment, and disgust) barriers to colorectal cancer (CRC) screening where, despite the benefits of early detection [10], screening rates are low
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