Wealth, health impact colon cancer screening

Good intentions don't always translate into action when it comes to colorectal cancer screening, researchers from the UK have found.

A person's health and socioeconomic status played a much more important role in whether or not they got screened for the disease than their stated intentions of doing so, Dr. Emily Power of University College London and her colleagues found.

"The results suggest that we need to help people to manage their screening goals more successfully," Power told Reuters Health. There's growing evidence, she added, that helping people to envisage potential barriers to getting screening tests and make plans to cope with them can increase follow-through.

Past research has demonstrated that a person's intention to perform a health-related task will influence whether or not they actually do it, Power and colleagues note in a report in the Annals of Behavioral Medicine. Nevertheless, she added in an interview, "there's still lots of people who say they're going to do something and don't end up doing it."

To better understand the factors involved, Power's team looked at 2,969 people who had been invited to participate in free colon cancer screening with a test called flexible sigmoidoscopy. While more than three-quarters said they would "definitely" or "probably" get the test, just 61 percent of these individuals actually got screened.

People who had less fatalistic beliefs about colorectal cancer, expected that the screening would give them "peace of mind," and thought that they would regret not getting screened were more likely to say they intended to undergo the test, the researchers found. But these factors had little to do with whether people actually got tested.

Instead, socioeconomic factors such as whether a person owned or rented their home, whether they had access to a car, and whether they were in good health were more important. For example, renters, people with no access to a car, and people in poor health were less likely to get the screening test.

"Maybe screening becomes less of a concern over time in the face of competing priorities that come up," Power said, noting that the screening test also requires people to undergo a rather unpleasant bowel preparation beforehand. "That may have also been a barrier to people who have lots of stuff going on anyway."

Helping people make detailed plans on when, how and where they are going to undergo screening tests - as well as the necessary preparations - could help people follow through on their intentions, she concluded.

SOURCE: Annals of Behavioral Medicine 2008.