Screening Intention Prediction of Colorectal Cancer among Urban Chinese Based on the Protection Motivation Theory

Abstract

Colorectal cancer poses a serious threat worldwide. Although early screening has been proved to be the most effective way to prevent and control colorectal cancer, the current situation of colorectal cancer screening remains not optimistic. The aim of this article is to apply the protection motivation theory (PMT) to examine the influencing factors on screening intention of colorectal cancer (CRC). This cross-sectional survey was launched in five communities in Wuhan, China. All the eligible urban Chinese were recruited and interviewed using paper-and-pencil questionnaires. The intention of colorectal cancer screening (CRCS) was measured using six PMT subconstructs, including perceived risk, perceived severity, fear arousal, response efficacy, response cost, and self-efficacy. Data on sociodemographic variables and knowledge of CRC were also collected. The structural equation modeling (SEM) method was used for data analysis. Among all the 569 respondents, 83.66% expressed willingness to participate in CRCS. Data of the research fit the proposed SEM model well (Chi-square/df = 2.04, GFI = 0.93, AGFI = 0.91, CFI = 0.91, IFI = 0.91, RMSEA = 0.04). Two subconstructs of PMT (response efficacy and self-efficacy) and CRC knowledge were directly and positively associated with screening intention. Age, social status, medical history, physical activity, and CRC knowledge were indirectly related to the screening intention through at least one of the two PMT subconstructs (response efficacy and self-efficacy). The findings of this study suggest the significance of enhancing response efficacy and self-efficacy in motivating urban Chinese adults to participate in CRC screening. Knowledge of CRC is significantly associated with screening intention. This study can provide useful information for the formulation and improvement of colorectal cancer screening strategies and plans.

Screening intention of MTs-DNA test for Colorectal Cancer screening and associated factors among hospital-based populations in southeastern China

“…The rate of willingness to accept and pay for CRC screening ranged from 67-91% in previous studies, but most studies focused on disease screening intentions or the use of colonoscopy [26][27][28] . The present study is the rst to focus on people's willingness to accept and pay for MTs-DNA test for CRC screening and found similar results.…”

Anticipatory anxiety and participation in cancer screening. A systematic review

“…(2022) showed that the relationship between fear arousal around a cancer diagnosis and bowel cancer screening intention became statistically non-significant when variables such as risk and severity perception, response efficacy and cost variables were entered into the model. 53 Fear specific to receiving a cancer diagnosis was reported as a reason for not participating in bowel cancer screening for 0%-50.4% of participants across three studies. 28,29,31 For example, one Dutch study found that fear of bowel cancer diagnosis was the second most common barrier to screening, reported by 11% of those who declined an FOBT.…”

“…Eleven negative relationships between anticipatory anxiety constructs and bowel cancer screening intention and behaviour were identified within the studies reviewed. 25,43,[48][49][50][51][52][53][54] All but one of the studies examining the worry or fear (n = 6) specific to the testing procedure showed that higher worry or fear was associated with reduced screening intentions and behaviour. 25,43,48,50,52 In one sample of 1633 African Americans, findings were different when examining behaviour versus intentions.…”

The acceptance of SARS‐CoV‐2 rapid antigen self‐testing: A cross‐sectional study in China

“…In previous studies, PMT has been used successfully to explain people's intention to take vaccines 12 , 13 , 14 or screen for cancer. 15 , 16 However, some recent studies have found that other factors which are not specifically mentioned in traditional PMT, such as the level of knowledge, should be an important factor when explaining the intention of vaccination uptake. 17 , 18 It suggests that the classical PMT should be appropriately extended to increase its predictive performance.…”

“…It had been widely used to predict the motivation of protecting oneself from dangers such as infectious diseases. In previous studies, PMT has been used successfully to explain people's intention to take vaccines 12–14 or screen for cancer 15,16 . However, some recent studies have found that other factors which are not specifically mentioned in traditional PMT, such as the level of knowledge, should be an important factor when explaining the intention of vaccination uptake 17,18 .…”