title: Cancer fear: facilitator and deterrent to participation in colorectal cancer screening.
abstract: BACKGROUND
  Cancer fear has been associated with higher and lower screening uptake across different studies, possibly because different aspects of cancer fear have different effects on intentions versus behavior. The present study examined associations of three aspects of cancer fear with intention and uptake of endoscopic screening for colorectal cancer.
  
  
  METHODS
  A subsample of UK Flexible Sigmoidoscopy (FS) Trial participants received a baseline questionnaire that included three cancer fear items from a standard measure asking if: (i) cancer was feared more than other diseases, (ii) cancer worry was experienced frequently, and (iii) thoughts about cancer caused discomfort. Screening intention was assessed by asking participants whether, if invited, they would accept an invitation for FS screening. Positive responders were randomized to be invited or not in a 1:2 ratio. The behavioral outcome was clinic-recorded uptake. Control variables were age, gender, ethnicity, education, and marital status.
  
  
  RESULTS
  The questionnaire return rate was 60% (7,971/13,351). The majority (82%) intended to attend screening; 1,920 were randomized to receive an invitation, and 71% attended. Fearing cancer more than other diseases (OR = 2.32, P < 0.01) and worrying a lot about cancer (OR = 2.34, P < 0.01) increased intentions to attend screening, but not uptake. Finding thoughts about cancer uncomfortable did not influence intention, but predicted lower uptake (OR = 0.72, P < 0.01).
  
  
  CONCLUSIONS
  Different aspects of cancer fear have different effects on the decision and action processes leading to screening participation.
  
  
  CONCLUSIONS
  Knowledge of the different behavioral effects of cancer fear may aid the design of effective public health messages.
authors: Epidemiology and Public Health, University College London, London, United Kingdom. j.wardle@ucl.ac.uk.
authors: Charlotte
authors: C
authors: Vrinten
authors: Epidemiology and Public Health, University College London, London, United Kingdom.
authors: Jo
authors: J
authors: Waller
authors: Epidemiology and Public Health, University College London, London, United Kingdom.
authors: Christian
authors: C
authors: von Wagner
authors: Epidemiology and Public Health, University College London, London, United Kingdom.
authors: Jane
authors: J
authors: Wardle
mesh_terms: D015179:Colorectal Neoplasms / Q000517:prevention & control / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D011446:Prospective Studies; D011634:Public Health; D012812:Sigmoidoscopy / Q000523:psychology*; D011795:Surveys and Questionnaires
references: J Immigr Minor Health. 2010 Aug;12(4):462-9
references: 19621259
references: Lancet. 2010 May 8;375(9726):1624-33
references: 20430429
references: BMC Public Health. 2013;13:677
references: 23879593
references: BMC Cancer. 2014;14:597
references: 25129323
references: Ann Behav Med. 2000 Winter;22(1):80-8
references: 10892532
references: Obstet Gynecol. 2000 Jul;96(1):70-4
references: 10862845
references: J Public Health (Oxf). 2015 Jun;37(2):322-7
references: 24850101
references: J Med Screen. 2001;8(3):137-44
references: 11678553
references: J Epidemiol Community Health. 2001 Dec;55(12):895-904
references: 11707484
references: Cancer Epidemiol Biomarkers Prev. 2003 Apr;12(4):314-20
references: 12692105
references: Cancer Epidemiol Biomarkers Prev. 2004 Apr;13(4):501-10
references: 15066912
references: J Health Psychol. 2004 Nov;9(6):753-62
references: 15367754
references: J Epidemiol Community Health. 1994 Feb;48(1):65-73
references: 8138773
references: Psychooncology. 2005 Jul;14(7):517-34
references: 15490428
references: Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):228-37
references: 16492909
references: Prev Med. 2006 Jun;42(6):401-8
references: 16626796
references: J Health Psychol. 2007 Jan;12(1):53-65
references: 17158840
references: Cancer Epidemiol Biomarkers Prev. 2008 Jul;17(7):1631-9
references: 18628414
references: Health Educ Behav. 2008 Aug;35(4):478-93
references: 17978053
references: Med Decis Making. 2013 Feb;33(2):271-81
references: 23468476