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Abstract
Objectives Colorectal cancer (CRC) screening uptake in Scotland is 56%. This study examined whether psychological factors were associated with CRC screening uptake.
Design Cross-sectional observational study.
Setting This study used data from the Healthy AGeing In Scotland (HAGIS) pilot study, a study designed to be representative of Scottish adults aged 50 years and older.
Participants 908 (505 female) Scottish adults aged 50–80 years (mean age=65.85, SD=8.23), who took part in the HAGIS study (2016–2017).
Primary and secondary outcome measures Self-reported participation in CRC screening was the outcome measure. Logistic regression was used to test whether scores on measures of health literacy, cognitive ability, risk aversion, time preference (eg, present oriented or future oriented) and personality were associated with CRC screening when these psychological factors were entered individually and simultaneously in the same model.
Results Controlling for age, age-squared, sex, living arrangement, and sex*living arrangement, a one-point increase in risk aversion (OR=0.66, 95% CI 0.51 to 0.85) and present orientation (OR=0.86, 95% CI 0.80 to 0.94) was associated with reduced odds of screening. Higher scores on health literacy (OR per one-point increase=1.20, 95% CI 1.09 to 1.31), cognitive ability (OR per SD increase=1.51, 95% CI 1.25 to 1.81) and the intellect personality trait (OR per one-point increase=1.05, 95% CI 1.01 to 1.09) were associated with increased odds of screening. Higher risk aversion was the only psychological variable that was associated with CRC screening participation when all psychological variables were entered in the same model and remained associated with CRC screening when additionally adjusting for deprivation and education. A backward elimination model retained two psychological variables as correlates of CRC screening: risk aversion and cognitive ability.
Conclusion Individuals who are more risk averse are less likely to participate in free, home CRC screening.
- epidemiology
- public health
- statistics & research methods
Data availability statement
Data are available on reasonable request. The anonymised HAGIS pilot data will be made available via the Gateway to Global Aging Data: https://g2aging.org/.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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Data availability statement
Data are available on reasonable request. The anonymised HAGIS pilot data will be made available via the Gateway to Global Aging Data: https://g2aging.org/.
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REO and IJD contributed equally.
Contributors CF-R contributed to the conception and design of the project, analysed the data, interpreted the data and drafted the initial manuscript. CBM contributed to the conception and design of the project, analysed the data, interpreted the data and drafted the initial manuscript. MvdP contributed to the statistical analysis of the data, interpreted the data and critically revised the manuscript. ED interpreted the data and critically revised the manuscript. DB interpreted the data and critically revised the manuscript. REO'C contributed to the conception and design of the project, interpreted the data and critically revised the manuscript. IJD contributed to the conception and design of the project, interpreted the data and critically revised the manuscript.
Funding This work was supported by the University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Well-being Initiative, funded by the Biotechnology and Biological Sciences Research Council and Medical Research Council (grant number: MR/K026992/1). The Healthy AGeing in Scotland (HAGIS) study (data resource) was part-funded by the National Institute of Ageing (grant number: RAG044535A) in the USA and was also part-funded by the Nuffield Foundation (grant number: OPD/42197). MvdP is supported by the Chief Scientist Office (CSO) of the Scottish Government Health and Social Care Directorates (grant number: not applicable).
Disclaimer The views expressed are those of the authors and not necessarily those of the foundation. The views expressed here are those of the unit and not necessarily those of the CSO.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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