Abstract
BackgroundKidney cancer is often asymptomatic, leading to proposals for a screening programme. The views of the public towards introducing a new screening programme for kidney cancer are unknown. The aim of this study was to explore attitudes towards kidney cancer screening and factors influencing intention to attend a future screening programme.MethodsWe conducted an online population-based survey of 1021 adults aged 45–77 years. The main outcome measure was intention to attend four possible screening tests (urine, blood, ultrasound scan, low-dose CT) as well as extended low-dose CT scans within lung cancer screening programmes. We used multivariable regression to examine the association between intention and each screening test.ResultsMost participants stated that they would be ‘very likely’ or ‘likely’ to undergo each of the screening tests [urine test: n = 961 (94.1%); blood test: n = 922 (90.3%); ultrasound: n = 914 (89.5%); low-dose CT: n = 804 (78.8%); lung CT: n = 962 (95.2%)]. Greater intention to attend was associated with higher general cancer worry and less perceived burden/inconvenience about the screening tests. Less worry about the screening test was also associated with higher intention to attend, but only in those with low general cancer worry (cancer worry scale ≤ 5). Compared with intention to take up screening with a urine test, participants were half as likely to report that they intended to undergo blood [OR 0.56 (0.43–0.73)] or ultrasound [OR 0.50 (0.38–0.67)] testing, and half as likely again to report that they intended to take part in a screening programme featuring a low dose CT scan for kidney cancer screening alone [OR 0.19 (0.14–0.27)].ConclusionParticipants in this study expressed high levels of intention to accept an invitation to screening for kidney cancer, both within a kidney cancer specific screening programme and in conjunction with lung cancer screening. The choice of screening test is likely to influence uptake. Together these findings support on-going research into kidney cancer screening tests and the potential for combining kidney cancer screening with existing or new screening programmes.
Highlights
Kidney cancer is often asymptomatic, leading to proposals for a screening programme
We aimed to explore the attitudes of the public towards potential future screening programmes for kidney cancer with different tests and to understand the individual and system-level factors influencing intention to take up screening
Based on demographic data on the Prolific website, approximately 80% of these were White/Caucasian, 34% male, 53% lived in the UK, 33% lived in the US, 15% were current smokers and 43% had a university level education. 51% considered themselves to be in the top five deciles of socioeconomic status
Summary
Kidney cancer is often asymptomatic, leading to proposals for a screening programme. The views of the public towards introducing a new screening programme for kidney cancer are unknown. Harvey‐Kelly et al BMC Urol (2020) 20:170 programme, potentially in a selected higher risk population, may down-stage the disease, reduce the prevalence of metastatic tumours at diagnosis, improve survival and decrease the expenditure related to systemic therapies [5]. Our group reported a detailed cost-effectiveness analysis of ultrasound scanbased screening. This suggested that screening may have acceptable cost-effectiveness in men aged 50–60y (£18–22k/QALY) and in women aged 60 if the prevalence of kidney cancer is at least 0.2% [6]. When combined with other CT scan-based screening programmes, such as current lung cancer screening pilots [7], additional screening for kidney cancer by CT scan has the potential to provide health and economic benefits. Research into new urinary (i.e. perilipin 1 and aquaporin 2 [8]) and blood based markers (i.e. KIM-1 [9]) is on-going and these may provide additional options for screening in the future
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