Public understanding of the purpose of cancer screening: a population-based survey
1UCL, London, UK
Cancer screening tests vary in whether their primary aim is to prevent cancer (through treatment of pre-cancerous lesions) or to detect cancer before symptoms emerge. Fear about what a screening test might find is often cited as barrier to participation, suggesting that if the public were aware that two tests (cervical screening and flexible sigmoidoscopy) were primarily preventive, this might reduce fear and increase uptake.
We carried out a population based, face-to-face interview survey with 1,464 adults in or close to the screening age range (50-70 years) across Great Britain. They were asked whether they thought the primary aim of cervical, breast, faecal occult blood test (FOBT), and flexible sigmoidoscopy (FS) screening was to prevent cancer or detect it early.
There was no sign that people were aware of the differences between the screening tests. Among women, 78% thought breast cancer aimed to detect cancer early, and the figure was only slightly lower at 72% for cervical cancer (only 19% knew it aims to prevent cancer). For colorectal screening (in men and women), 72% knew that FOBT aims to detect cancer early, but 70% also (incorrectly) thought that FS is primarily for early detection. Among 519 women aged 50-64 (i.e. eligible for cervical screening, a long-standing NHS programme), awareness of the preventive aims of the test was not associated with age, social class, or previous screening participation, suggesting knowledge is low across the board.
Greater efforts may be needed to communicate the potential preventive role of cervical and FS screening, and give the public a more nuanced understanding of the differences between different cancer screening tests.