Cancer Screening Intentions Research Articles

Determinants of Prostate Cancer Screening Intentions of Young Black Men Aged 18 to 40Years.

Black men are more likely to be diagnosed with prostate cancer, with higher stage and higher grade at presentation. Evidence suggests that for education in health promotion behaviors (such as screenings) in early adult years, young Black men can be better equipped to make informed decisions in later years. Using the theory of reasoned action (TRA), we assessed the intention of young Black men to screen for prostate cancer when it is recommended and determined its correlates. This was a cross-sectional study of 267 Black men aged 18 to 40years. A 47-item questionnaire collected information on demographics/personal factors, attitudes toward prostate cancer screening, social influence, comfortability with prostate examinations, cues to action, health screening experiences, knowledge of prostate cancer and screening, and intention. Descriptive statistics were calculated for all variables and hierarchical logistic regression was employed to determine significant predictors of prostate cancer screening intentions. The regression model accounted for 46% of the variance in intention (p<0.01), with excellent perception of health, having private or public health insurance, longer regular source of care, positive attitude, positive social influence, positive cues to action, and higher knowledge levels being significant predictors of intentions. This study provides support for the use of TRA in predicting prostate cancer screening intentions among young Black men when it is recommended by a physician. Findings may inform the development of empirical-based interventions to educate and inform at-risk young Black men about the pros and cons of prostate cancer screening so that they can make informed decision on screening when recommended later in life.

Predictors of prostate cancer screening intention among older men in Jordan

ABSTRACTIntention to prostate cancer screening (PCS) is one of the major factors affecting the long‐term success of population‐based PCS programmes. The aim of this study is to explore strong factors linked to intention to PCS among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care centre within a ministry of health. A pilot test was conducted to investigate the internal consistency of the Champion Health Belief Model Scale for PCS and the clarity of survey questions. Sample characteristics and rates of participation in PCS were examined using means and frequencies. Important factors associated with intention to PCS were examined using bivariate correlation and standard multiple linear regression analysis. About 13% of the respondents were adherent to PCS over the prior decade. Four out of the seven HBM‐driven factors (perceived susceptibility, benefits and barriers to prostate‐specific antigen (PSA) test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were having more intention to participate in PCS. Family history, presence of urinary symptoms, age and knowledge about prostate cancer significantly predicted the intention to PCS. Intervention programmes, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.

A Cross-sectional Investigation of Cancer-Screening Intentions, Sources of Information, and Understanding of Cancer in Japanese Adolescents.

The purpose of this study was to describe the cancer-screening intention, sources of cancer information, and cancer understanding among Japanese adolescents. A cross-sectional nationwide survey involving a self-administered questionnaire was conducted. Response rates of the target schools were 46.4 % (n = 103) for junior high schools and 55.8 % (n = 116) for high schools. From these, we analyzed the data of 2960 junior high school students (1520 males, 1440 females) and 3703 high school students (1546 males, 2157 females) to examine the association between cancer-screening intention and sources of cancer-related information and understanding. A significant association between cancer-screening intention and sources of cancer information and cancer understanding was observed. The screening intention group identified more sources of cancer information than the no-screening intention group did. Understanding about cancer was reported by a higher proportion of students in the screening intention group compared with the no-screening intention group. Recognition that healthy people must take part in cancer screening was significantly associated with screening intention in both junior high (odds ratio (OR), 1.859; 95% confidence interval (CI), 1.582-2.185; P < 0.001) and high school (OR, 2.485; 95% CI, 2.139-2.887; P < 0.001) students. Health education at school was indicated by a high proportion of students as a source of cancer-related information, although the association was not significant. The present survey indicated that those in of our sample who intended to undergo future cancer screening (67.8 %) had more sources of information and understanding regarding cancer. Thus, schools should enrich health education curricula with more information and understanding about cancer to promote cancer-screening intention among Japanese adolescents.

The influence of the ‘cancer effect’ on young women’s responses to overdiagnosis in cervical screening

ObjectivesTo examine the ‘cancer effect’ (higher risk perceptions and negative emotion in cancer-related contexts) on young women’s responses to overdiagnosis (identification and treatment of inconsequential disease) in cervical cancer screening. MethodsIn a randomised experimental study, 168 women aged 17–24 read 1 of 4 texts outlining benefits and harms of cervical cancer screening or a fictitious non-cancer screening test; each presented with or without overdiagnosis information. Screening intentions and psychosocial outcomes were measured (T1). Overdiagnosis information was then presented to participants who did not receive it initially and intentions reassessed (T2). ResultsMean screening intentions were not significantly different across groups. The distribution of intentions for cancer vs non-cancer screening differed significantly. Cancer information led to more extreme responses. Participants receiving overdiagnosis information at T2 reduced their screening intentions significantly. Perceived risk of disease was lower when overdiagnosis information was presented (non-cancer condition only). Higher negative emotion predicted higher screening intentions (cancer condition only). ConclusionsThis pattern of results suggests that a ‘cancer effect’ may be present among young women given identical information about cancer and non-cancer screening. Practice implicationsThe ‘cancer effect’ may contribute to community eagerness for cancer screening despite provision of information about harms like overdiagnosis.

Abstract B71: The effect of knowledge on cancer screening intentions and behaviors among African Americans

Abstract Background: Early cancer detection is widely recommended to reduce cancer mortality, for cancer is most successfully treated during the early stage. In Maryland, only 44.6% of all cancers are detected at the early stage, which may partially account for the fact that blacks in Baltimore City experience significantly higher mortality rates related to breast, cervical, and colorectal cancers. Access to cancer screening and early detection services and early education are critical in reducing cancer mortality and disparities. Past studies have examined the factors that influence cancer-screening behaviors, however, few have directly assessed how the association between knowledge and behavioral intentions relative to cancer screening varies with age. Methods: The data was collected from the Advancing Community Outreach Study (March 2014-June 2015) conducted by the Johns Hopkins Center to Reduce Cancer Disparities in collaboration with community partners in Baltimore City. The data was obtained via convenience sampling at health fairs and community presentations, and study participants (n=294) responded to various questions to assess knowledge, attitudes, and behavioral intentions based on past and future communications with a health care provider about screening for breast, cervical, and colorectal cancers. Cancer knowledge focused on screening methods and National Cancer Institute's recommendations for screening. The primary outcome measure was defined by behavioral intentions indicated by the participant. Results: Preliminary analyses showed that the study population was 83.1% female and 88.5% black. Individuals were separated into three age groups (&amp;lt;50, 50-59, and &amp;gt;60 years of age) to examine the association between cancer screening knowledge and behaviors/intentions. Significant differences in knowledge of cervical cancer (p=0.030) and colorectal cancer (p&amp;lt;0.000) screening guidelines by age group were noted. Past actions related to getting cancer screening varied with age as well. After adjusting for differences in age, gender, and race, positive associations were found between knowledge of cervical cancer screening guidelines and past actions (OR, 3.4; 95% CI, 1.5-7.7) as well as between knowledge of colorectal cancer screening guidelines and past actions (OR, 4.2; 95% CI, 1.7-10.2). Stratifying by age groups indicated that individuals under 50 with knowledge of cervical cancer screening guidelines had higher odds of having positive intentions (OR, 3.6; 95% CI, 1.1-12.3) and positive past actions (OR, 11.1; 95% CI, 1.8-66.3). A positive association was also found in individuals over 60 with knowledge of colorectal cancer screening guidelines, for they had higher odds of both positive health intentions (OR, 5.2; 95% CI, 1.0-27.3) and past actions (OR, 6.7; 95% CI, 1.2-38.3). Knowledge of breast, cervical, and colorectal cancer screening methods was high across the study population (% individuals with correct knowledge &amp;gt;92.0 in all knowledge questions) and showed non-significant differences by age group. Conclusions: Study findings suggest that individuals closer in age to a specific cancer screening guideline demonstrate a positive association between cancer screening knowledge and behavioral intentions linked to obtaining cancer screening. The findings highlight the importance of increasing early and consistent education about cancer screenings to encourage early detection of cancer and to ultimately reduce the disparity in cancer mortality rates. Further research should be conducted to explore the additional factors that influence knowledge of cancer screening methods and guidelines and how that level of knowledge affects cancer screening behaviors. Citation Format: Anjani D. Kapadia, Ahmed Elmi, Lee Bone, Caryn Bell, Saad Tussaduq, Theron Scott, Olive Mbah, Adrian Dobs. The effect of knowledge on cancer screening intentions and behaviors among African Americans. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B71.

Responses to Overdiagnosis in Thyroid Cancer Screening among Korean Women.

PurposeCommunicating the harms and benefits of thyroid screening is necessary to help individuals decide on whether or not to undergo thyroid cancer screening. This study was conducted to assess changes in thyroid cancer screening intention in response to receiving information about overdiagnosis and to determine factors with the greatest influence thereon.Materials and MethodsData were acquired from subjects included in the 2013 Korean National Cancer Screening Survey (KNCSS), a nationwide, population-based, cross-sectional survey. Of the 4,100 respondents in the 2013 KNCSS, women were randomly subsampled and an additional face-to-face interview was conducted. Finally, a total of 586 female subjects were included in this study. Intention to undergo thyroid cancer screening was assessed before and after receiving information on overdiagnosis.ResultsPrior awareness of overdiagnosis in thyroid cancer screening was 27.8%. The majority of subjects intended to undergo thyroid cancer screening before and after receiving information on overdiagnosis (87% and 74%, respectively). Only a small number of subjects changed their intention to undergo thyroid cancer screening from positive to negative after receiving information on overdiagnosis. Women of higher education level and Medical Aid Program recipients reported being significantly more likely to change their intention to undergo thyroid cancer screening afterreceiving information on overdiagnosis,whilewomen with stronger beliefs on the efficacy of cancer screening were less likely to change their intention.ConclusionWomen in Korea appeared to be less concerned about overdiagnosis when deciding whether or not to undergo thyroid cancer screening.

Web-Based Study for Improving Mammography Among Korean American Women.

Web-based culture-specific interventions for Korean American (KA) women to improve mammography utilization are not available. An established intervention developed to improve mammography utilizations for Korean American (KA) women was tested via the Web for its efficacy, feasibility, and acceptability. A randomized controlled trial, with a pretest-posttest control group design, was conducted with 136 KA women and their spouses. Intention to have a mammogram within the next 12months increased significantly in the intervention group compare to controls. Among women whose mammograms had not been updated, 22% of women in the intervention and 13% of women in the control group obtained a mammogram at 2-month post-baseline, even though the difference was not statistically significant. The Web-based study educating couples was feasible and could improve KA women's breast cancer screening intention and behaviors. Combining off-line contact for recruitment/data collection with online intervention material could decrease the attrition rate in the future study because the attrition rate in this study was higher than the original study.

A Three-Factor Cancer-Related Mental Condition Model and Its Relationship With Cancer Information Use, Cancer Information Avoidance, and Screening Intention

Cancer-related affect and cognition, such as cancer fear, cancer worry, and cancer risk perception, are important predictors of cancer prevention and communication behaviors. However, they have not been clearly conceptualized in cancer communication literature, and in particular, the role of affect (i.e., cancer fear) in cancer prevention and communication has not been fully investigated. The present study developed a 3-factor cancer-related mental condition model encompassing affective (cancer fear), cognitive (cancer risk perception), and affective-cognitive (cancer worry) conditions. Two studies were conducted. Study 1 developed the model with Sample 1 (U.S. undergraduates, N = 309), and subsequently validated the model with Sample 2 (Korean general population, ages 40 years or older, N = 1,130). Study 2, using Sample 2, tested the model's relationship with cancer information use, cancer information avoidance, and screening intention. While Sample 1 participants were asked about cancer in general, Sample 2 participants were asked specifically about stomach cancer. Thus, the model derived from the specific sample in a general context was confirmed via the general sample in a specific context. The results showed that both cancer worry and cancer risk perception are positively associated with cancer information use and screening intention, but they are negatively associated with cancer information avoidance. Cancer fear was positively associated with cancer information use, but it was also positively related to cancer information avoidance. Moreover, cancer fear was negatively associated with screening intention. Although the three components of the model are positively related to one another, they function differently in the cancer context.

Abstract P1-11-12: Religion-related factors and breast cancer screening among American Muslims

Abstract Background: Cancer disparities research often overlooks the influence a shared religion may have across race and ethnicity, and thereby misses opportunities to leverage shared religious networks to promote screening. While American Muslims have low rates of mammography and their health behaviors are strongly influenced by religion, a description of such relationships is lacking in the literature. Our study fills this gap. Methods: We conducted a mixed-methods exploration of how religion-related factors impact breast cancer screening practices. We sampled an ethnically and racially diverse group of Muslim women frequenting mosques and community sites. A survey incorporated measures of fatalism, religiosity, religious discrimination, and Islamic modesty, while subsequent focus groups elicited perspectives on how religious beliefs, values and identity impact breast cancer screening intentions. Survey analyses involved logistic regression models, while focus groups were analyzed using a team-based framework content analysis approach. Results: Of 240 survey respondents, 72 were Arabs, 71 S. Asians and 59 African Americans. Seventy-five percent had insurance, while 85% had a PCP. 77% reported ever having a mammogram while only 37% a mammogram within the past 2 years. In multivariate models, positive religious coping (OR= 0.21;P &amp;lt;.05) and perceived religious discrimination in healthcare (OR=0.74;P &amp;lt;.05) were negatively associated with having a mammogram in the past two years, while having a primary care physician (OR=20;P&amp;lt;.01) was positively associated. Ever having a mammogram was positively associated with increasing age (OR=1.1;P&amp;lt;.05), years of US residency (10-20 yrs OR=11; 20 yrs OR=4.3;P&amp;lt;.05) and knowing someone with breast cancer (OR=3.5;P&amp;lt;.01). Importantly, ethnic/racial affiliation did not influence mammography rates. Of 50 focus group participants there were nearly equal numbers of S. Asians, Arabs, and African Americans, 74% reported ever having a mammogram, with 56% having a mammogram within the past two years. Focus group data revealed that family support and encouragement strongly impacted screening intentions, and that obtaining screening in a way that accommodated notions of religious modesty was paramount and prior experiences with such accommodations influenced subsequent intentions. Focus group participants believed that the mosque is a critical community venue for setting religious mores but is underutilized for health education and for motivating theological responses to illness. Participants expressed the need for mosque administration and religious leaders to openly discuss breast health and mammography screening among the Muslim community. Conclusions: Aspects of religion appear to influence cancer screening behaviors similarly across the socioeconomic, ethnic, and racial diversity of American Muslims. Promoting biennial mammography screening among American Muslims requires addressing ideas about religious coping as related to preventive cancer screening and empowering women to combat perceived religious discrimination. Mosques are underutilized in breast cancer screening interventions but are a ripe setting for religiously-tailored programming that can address barriers to screening and promote a culture of health in this community. Citation Format: Aasim Padela, S Murrar, S Mallick, Z Hosseinain, C Liao, C Ajax, F Marfani, M Peek. Religion-related factors and breast cancer screening among American Muslims [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-11-12.

The impact of supplementary narrative-based information on colorectal cancer screening beliefs and intention

BackgroundThe potential benefits of colorectal cancer screening are limited by low uptake. This study tested whether providing narrative accounts of the colorectal cancer (CRC) screening experience positively affected beliefs about CRC screening and intention to be screened.Methods4125 adults aged 45-59.5 years, from three general practices in England, were randomised to be sent the standard information on CRC screening or the standard information plus a narrative-based leaflet describing CRC screening experiences. Both groups were asked to complete and return a questionnaire on beliefs about CRC screening after reading the study materials. Between-group differences on responses were assessed with t-tests. A mediation analysis then addressed the mediating role of CRC screening beliefs on the group and intention relationship.ResultsRelative to the standard information group (n = 590), the standard information plus narrative leaflet group (n = 631) showed higher perceived vulnerability to CRC, higher perceived test response efficacy, a stronger belief that the screening test would provide peace of mind and less disgust with the test procedure. There were no between group differences on perceived self-efficacy or the understanding that the screening test should be done in the absence of symptoms. Respondents who received the additional narrative leaflet reported significantly higher CRC screening intentions than respondents who received the standard information only. Controlling for the CRC screening beliefs reduced the effect of group on intention to non-significance.ConclusionsAn additional narrative leaflet had a positive impact on beliefs about CRC screening which led to stronger screening intentions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1167-3) contains supplementary material, which is available to authorized users.

Relationship between body image and breast self-examination intentions and behavior among female university students in Malaysia.

This study aimed to examine the relationship between body image satisfaction and breast self-screening behavior and intentions. The sample for this cross-sectional study consisted of 842 female university students who were recruited from a number of public and private universities. Data were obtained between the months of November and December, 2013, using multistage random cluster sampling. Main research variables were breast cancer screening behavior and intentions, demographic factors, and the total scores on each of the Multidimensional Body-Self Relations Questionnaire (MBSRQ-Appearance Scales) subscales. Results of multivariate analysis showed that having higher satisfaction and more positive evaluation of appearance were related to having performed breast self-examination more frequently in the last year and intending to perform breast self-examination more frequently in the next year. Longitudinal research can potentially provide detailed information about overall body image satisfaction and breast cancer screening behavior among various communities.

Dense Breast Tissue Notification: Impact on Women’s Perceived Risk, Anxiety, and Intentions for Future Breast Cancer Screening

PurposeThe aim of this study was to explore how women respond to the wording of dense breast tissue notifications, which are increasingly required by state law after mammography. The specific aims were to (1) determine whether perceived lifetime risk for breast cancer and intentions to undergo mammography increase after reviewing a sample notification, (2) explore individual difference variables (eg, minority status, insurance coverage) that may influence intentions for additional ultrasound screening, and (3) assess whether anxiety mediates the relationship between perceived risk and screening intentions. MethodsA total of 184 women aged >40 years in the United States were recruited from Amazon Mechanical Turk to respond to a dense breast tissue notification as if they had personally received it. ResultsAfter reviewing a notification, women reported greater perceived risk (d = 0.67) and intentions to undergo mammography (d = 0.25) than before. Most women intended to undergo additional ultrasound screening, although to a lesser extent when ultrasound was covered by insurance than when it was not (d = 1.03). All screening intentions were lower in women with ambiguity aversion, a tendency to avoid tests without medical consensus, and those who preferred an active decision-making role. Anxiety mediated the relationship between perceived breast cancer risk and all screening intentions. ConclusionsWomen who receive dense breast tissue notifications may generally increase their breast cancer screening intentions; however, intention strength varies depending on internal (eg, ambiguity aversion) and external (eg, insurance for ultrasound) factors. Although perceived risk increases after notification, it is anxiety that drives women’s intentions for future screening.

Knowledge about cervical cancer screening and perception of risk among women attending outpatient clinics in rural Kenya

ObjectiveTo evaluate cervical cancer knowledge, risk perception, and screening intention among women attending outpatient clinics in rural Kenya. MethodsA cross-sectional oral survey was conducted among non-pregnant women aged 23–64years who attended one of 11 western Kenyan health facilities for any reason between March 25 and April 26, 2013. Demographic and clinical predictors were identified using bivariate and multivariate regression analyses. ResultsAmong 419 participants, 327 (78.0%) had heard of cervical cancer screening. Nevertheless, their specific knowledge was low (mean score 8.6±2.4 [out of 15.0]). Overall, 288 (68.7%) women felt at risk for cervical cancer, and 333 (79.5%) stated that they would undergo screening if offered. Women who intended to undergo screening were less likely to attend a district hospital (adjusted odds ratio [AOR] 0.4; 95% confidence interval [CI] 0.2–0.6) and more likely to have been diagnosed with HIV more than 4years previously (AOR 0.4; 95% CI 0.2–0.6). Additionally, increased screening acceptance was associated with high knowledge scores (P=0.004). ConclusionEducational interventions to increase knowledge about cervical cancer might increase screening uptake in low-income settings. Additionally, improvements in services at local health facilities could have a large effect.

Factors affecting cancer screening intention and behavior of the Korean elderly.

In this study we investigated factors influencing cancer screening intention and behavior to develop measures to increase the rate of cancer screening in the Korean elderly. Participants included 425 elderly subjects 65 years of age or older from D city, South Korea. The health behavior characteristics and cancer screening-related and theory of planned behavior (TPB) factors influencing the participant attitudes on cancer screening were examined to identify determinants significantly affecting cancer screening intentions and behavior. Predictive factors influencing cancer screening behavior included smoking, exercise, cancer concerns, preference for the type of cancer screening, prior experience with the National Cancer Screening Program, perception of the National Cancer Screening Program, behavioral control with respect to cancer screening and cancer screening intentions. The factors influencing cancer screening behavior were different from those for cancer screening intentions. Increasing the cancer screening intentions of the elderly is necessary to raise the rates of cancer screening. Additionally, identifying the inhibitory factors that serve as obstacles to cancer screening in the elderly and changing screening intentions into actual screening behavior is necessary. This study provides a reference for developing and applying policy measures and intervention strategies to increase the cancer screening rates of the elderly in Korea.

The effect of a supplementary ('Gist-based') information leaflet on colorectal cancer knowledge and screening intention: a randomized controlled trial.

Guided by Fuzzy Trace Theory, this study examined the impact of a ‘Gist-based’ leaflet on colorectal cancer screening knowledge and intentions; and tested the interaction with participants’ numerical ability. Adults aged 45–59 years from four UK general practices were randomly assigned to receive standard information (‘The Facts’, n = 2,216) versus standard information plus ‘The Gist’ leaflet (Gist + Facts, n = 2,236). Questionnaires were returned by 964/4,452 individuals (22 %). 82 % of respondents reported having read the information, but those with poor numeracy were less likely (74 vs. 88 %, p < .001). The ‘Gist + Facts’ group were more likely to reach the criterion for adequate knowledge (95 vs. 91 %; p < .01), but this was not moderated by numeracy. Most respondents (98 %) intended to participate in screening, with no group differences and no interaction with numeracy. The improved levels of knowledge and self-reported reading suggest ‘The Gist’ leaflet may increase engagement with colorectal cancer screening, but ceiling effects reduced the likelihood that screening intentions would be affected.Electronic supplementary materialThe online version of this article (doi:10.1007/s10865-014-9596-z) contains supplementary material, which is available to authorized users.

Changes in colorectal cancer screening intention among people aged 18–49 in the United States

BackgroundTo determine whether exposure to a peer-led intervention focused on colorectal cancer (CRC) screening, physical activity, and multi-vitamin intake can lead to increased intentions to be screened for CRC once age eligible among adults under the age of 50.MethodsParticipants were residents of low-income housing sites, and CRC screening intentions were assessed at baseline and at follow-up (approximately 2 years later) to determine changes in screening intentions and factors associated with changes in intentions.ResultsParticipants (n = 692) were 78.4% female, 42.6% Hispanic and 50.8% black. At follow-up, 51% maintained their intention to be screened and 14.6% newly intended to get screened. Individuals newly intending to get screened were more likely to have participated in the intervention, be older, male, and born in Puerto Rico or the United States compared to those who maintained their intention not to get screened (p < 0.05).ConclusionExposure to CRC prevention messages before the age of 50 can increase screening intentions among individuals who did not initially intend to get screened. Peer-led interventions to promote CRC screening should include individual less than 50 years of age, as this may contribute to increased screening at the recommended age threshold.

Examining Asian Women’s Motivations to Undergo Breast Cancer Screening

Purpose: This study utilizes Protection Motivation Theory as a theoretical framework to predict women’s intentions to go for mammogram screening in Singapore, a country with the highest incidence of breast cancer in Asia. Materials and Methods: A questionnaire centered on the theoretical predictive model of early detection behavior was developed to examine the hypothesized relationships. Data was collected from Singaporean women between 40 to 69 years of age. The data was analyzed using hierarchical regression. Results: Amongst all predictors tested, we found that Perceived Severity influences protection motivation (Beta=.346, p=.033), whereas Perceived Vulnerability has little effect on protection motivation (Beta= .075, p=. 355). There is also a significant relationship between Self-Efficacy and protection intention (Beta= .373, p<.001). However, contrary to expectations, neither Response Cost (Beta=.136, p=.101) nor Physical Cost (Beta=-.051, p=-.036) was related to protection intention. Conclusions: Our findings indicate that coping appraisal variables are more significantly associated with protection motivation than threat appraisal variables. In particular, self-efficacy was found to be the strongest predictor of breast cancer screening intentions, whereas response cost and physical cost were found to have little effect. This implies that breast cancer screening motivators should communicate the ease of undergoing the procedure and other confidence building messages. Implications for health education and policy are discussed.

The Influence of Gender on Colorectal Cancer Knowledge, Screening Intention, Perceived Risk and Worry Among African Americans in South Florida

The aim of this study was to examine if gender differences exist for colorectal cancer (CRC) knowledge, intention to screen, perceived risk and cancer worry among African Americans for CRC. African American males and females (N = 336) aged 45 years or older living in southeast Florida were recruited to participate in a cross-sectional survey that assessed intentions to screen as well as CRC knowledge, cancer worry, perceived risk. No significant differences were found between men and women in their intention to screen for CRC or in their worry about cancer. Results did suggest that men and women differed significantly about their understanding of CRC knowledge. Findings also showed that there were differences in perceived risk between genders, with female study participants possessing lower levels of risk than men. Study results suggest that future interventions need to ensure that females understand their risk for CRC and understand the benefits associated with CRC screening. Findings also suggest that interventions promoting CRC screening may need to be tailored if increased participation in CRC screening is to be achieved for women.

Preferences for Colorectal Cancer Screening Techniques and Intention to Attend: a Multi-Criteria Decision Analysis

Despite the expected health benefits of colorectal cancer screening programs, participation rates remain low in countries that have implemented such a screening program. The perceived benefits and risks of the colorectal cancer screening technique are likely to influence the decision to attend the screening program. Besides the diagnostic accuracy and the risks of the screening technique, which can affect the health of the participants, additional factors, such as the burden of the test, may impact the individuals' decisions to participate. To maximise the participation rate of a screening program for a new colorectal cancer program in the Netherlands, it is important to know the preferences of the screening population for alternative screening techniques. The aim of this study was to explore the impact of preferences for particular attributes of the screening tests on the intention to attend a colorectal cancer screening program. We used a web-based questionnaire to elicit the preferences of the target population for a selection of colon-screening techniques. The target population consisted of Dutch men and women aged 55-75 years. The analytic hierarchy process (AHP), a technique for multi-criteria analysis, was used to estimate the colorectal cancer screening preferences. Respondents weighted the relevance of five criteria, i.e. the attributes of the screening techniques: sensitivity, specificity, safety, inconvenience, and frequency of the test. With regard to these criteria, preferences were estimated between four alternative screening techniques, namely, immunochemical fecal occult blood test (iFOBT), colonoscopy, sigmoidoscopy, and computerized tomographic (CT) colonography. A five-point ordinal scale was used to estimate the respondents' intention to attend the screening. We conducted a correlation analysis on the preferences for the screening techniques and the intention to attend. We included 167 respondents who were consistent in their judgments of the relevance of the criteria and their preferences for the screening techniques. The most preferred screening method for the national screening program was CT colonography. Sensitivity (weight = 0.26) and safety (weight = 0.26) were the strongest determinants of the overall preferences for the screening techniques. However, the screening test with the highest intention to attend was iFOBT. Inconvenience (correlation [r] = 0.69), safety (r = 0.58), and the frequency of the test (r = 0.58) were most strongly related to intention to attend. The multi-criteria decision analysis revealed the attributes of the screening techniques that are most important so as to increase intention to participate in a screening program. Even though the respondents may recognize the high importance of diagnostic effectiveness in the long term, their short-term decision to attend the screening tests may be less driven by this consideration. Our analysis suggests that inconvenience, safety, and frequency of the test are the strongest technique-related determinants of the respondents' intention to participate in colorectal screening programs.

Understanding Cervical Cancer Screening Intentions among Latinas Using An Expanded Theory of Planned Behavior Model

We examined the utility of an expanded theory of planned behavior (TPB) model in predicting cervical cancer screening intentions among Latinas. The model included acculturation and past cervical cancer screening behavior along with attitude, subjective norms, and perceived behavioral control. This cross-sectional study included a sample of 206 Latinas who responded to a self-administered survey. Structural equation modeling was employed to test the expanded TPB model. Acculturation (p = .025) and past screening behavior (p = .001) along with attitude (p = .019), subjective norms (p = .028), and perceived behavioral control (p = .014) predicted the intention to be screened for cervical cancer. Our findings suggest that the TPB is a useful model for understanding cervical cancer screening intentions among Latinas when both past behavior and culture are included. This research highlights the importance of culture on behavior and indicates a need to develop culturally sensitive, theory-based interventions to encourage screening and reduce cervical cancer-related health disparities in Latinas.