Perceived Life Expectancy Is Associated with Colorectal Cancer Screening in England.
BACKGROUND
Cancer screening is a behavior that represents investment in future health. Such investment may depend on how much 'future' a person expects.


OBJECTIVE
The purpose of this study was to investigate the prospective association between perceived personal life expectancy and participation in fecal occult blood test screening for colorectal cancer (CRC) in a national program.


METHODS
Data were from interviews with 3975 men and women in the English Longitudinal Study of Ageing (ELSA) within the eligible age range for the national screening program (60 to 74 years). Perceived life expectancy was indexed as the individual's estimate of their chance of living another 10-15 years (exact time varied by age), assessed in 2008/2009. Participation in CRC screening from 2010 to 2012/2013 was assessed in 2012/2013. Logistic regression was used to estimate the association between perceived life expectancy and screening participation, adjusted for numeracy and known mortality risk factors.


RESULTS
Overall, 71% of respondents (2817/3975) reported completing at least one fecal occult blood test (FOBt) during the follow-up. Screening uptake was 76% (1272/1683) among those who estimated their 10-15-year life expectancy as 75-100%, compared with 52% (126/243) among those who estimated theirs as 0-25% (adjusted OR 1.74, 95% CI 1.29-2.34).


CONCLUSIONS
A longer perceived life expectancy is associated with greater likelihood of participating in CRC screening in England. However, half of people with a low perceived life expectancy still participated in screening. Given that CRC screening is recommended for adults with a remaining life expectancy of ≥10 years, future research should investigate how to communicate the aims of screening more effectively.
Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Harvard University, 9 Bow St, Cambridge, MA, 02138, USA. kobayashi@hsph.harvard.edu.|Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK. kobayashi@hsph.harvard.edu.
Lindsay C
LC
Kobayashi
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
Christian
C
von Wagner
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
Jane
J
Wardle
D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D010465:Perception
Behavioral economics; Cancer screening; Colorectal cancer; Fecal occult blood test; Perceived life expectancy