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Intentions to participate in cervical and colorectal cancer screening during the COVID-19 pandemic: A mixed-methods study

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Rebecca Wilson, Harriet Quinn-Scoggins, Yvonne Moriarty, Jacqueline Hughes, Mark Goddard, Rebecca Cannings-John, Victoria Whitelock, Katriina L. Whitaker, Detelina Grozeva, Julia Townson, Kirstie Osborne, Stephanie Smits, Michael Robling, Julie Hepburn, Graham Moore, Ardiana Gjini, Kate Brain, Jo Waller

Original languageEnglish
Article number106826
JournalPreventive Medicine
Volume153
DOIs
PublishedDec 2021

Bibliographical note

Funding Information: Economic and Social Research Council as part of UK Research and Innovation's Rapid Response to COVID-19 (ES/V00591X/1). The funders had no role in the design, conduct or analyses of this study.This study was facilitated by HealthWise Wales, the Health and Care Research Wales initiative, which is led by Cardiff University in collaboration with SAIL, Swansea University. HQS is funded by PRIME Centre Wales, which is funded by Welsh Government through Health and Care Research Wales. DECIPHer and The Centre for Trials Research receives funding from Health and Care Research Wales, and Health and Care Research Wales and Cancer Research UK respectively. SS is funded by a Health and Care Research Wales fellowship (514366). JW is funded by a Cancer Research UK Career Development Fellowship (C7492/A17219). We are grateful to Cancer Research UK's Cancer Insights Patient Panel, Clinical Advisory Panel and GP Panel for their helpful feedback. Cancer Research UK staff members and other researchers contributed to the initiation and development of the CAM, both historically and for this project. COVID-CAM data was provided by Cancer Research UK who collected the data via Dynata's online survey panels. External Scientific Advisory Group members who advised the statistical analysis plan include: Professor Jamie Brown (University College London), Professor Yoryos Lyratzopoulos (University College London), Dr. Katie Robb (University of Glasgow), Dr. Christian von Wagner (University College London) and Professor Fiona Walter (University of Cambridge). Funding Information: This study was facilitated by HealthWise Wales, the Health and Care Research Wales initiative, which is led by Cardiff University in collaboration with SAIL, Swansea University. HQS is funded by PRIME Centre Wales , which is funded by Welsh Government through Health and Care Research Wales. DECIPHer and The Centre for Trials Research receives funding from Health and Care Research Wales , and Health and Care Research Wales and Cancer Research UK respectively. SS is funded by a Health and Care Research Wales fellowship ( 514366 ). JW is funded by a Cancer Research UK Career Development Fellowship ( C7492/A17219 ). We are grateful to Cancer Research UK's Cancer Insights Patient Panel, Clinical Advisory Panel and GP Panel for their helpful feedback. Cancer Research UK staff members and other researchers contributed to the initiation and development of the CAM, both historically and for this project. COVID-CAM data was provided by Cancer Research UK who collected the data via Dynata's online survey panels. External Scientific Advisory Group members who advised the statistical analysis plan include: Professor Jamie Brown (University College London), Professor Yoryos Lyratzopoulos (University College London), Dr. Katie Robb (University of Glasgow), Dr. Christian von Wagner (University College London) and Professor Fiona Walter (University of Cambridge). Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Worldwide, cancer screening faced significant disruption in 2020 due to the COVID-19 pandemic. If this has led to changes in public attitudes towards screening and reduced intention to participate, there is a risk of long-term adverse impact on cancer outcomes. In this study, we examined previous participation and future intentions to take part in cervical and colorectal cancer (CRC) screening following the first national lockdown in the UK. Overall, 7543 adults were recruited to a cross-sectional online survey in August–September 2020. Logistic regression analyses were used to identify correlates of strong screening intentions among 2319 participants eligible for cervical screening and 2502 eligible for home-based CRC screening. Qualitative interviews were conducted with a sub-sample of 30 participants. Verbatim transcripts were analysed thematically. Of those eligible, 74% of survey participants intended to attend cervical screening and 84% intended to complete home-based CRC screening when next invited. Thirty percent and 19% of the cervical and CRC samples respectively said they were less likely to attend a cancer screening appointment now than before the pandemic. Previous non-participation was the strongest predictor of low intentions for cervical (aOR 26.31, 95% CI: 17.61–39.30) and CRC (aOR 67.68, 95% CI: 33.91–135.06) screening. Interview participants expressed concerns about visiting healthcare settings but were keen to participate when screening programmes resumed. Intentions to participate in future screening were high and strongly associated with previous engagement in both programmes. As screening services recover, it will be important to monitor participation and to ensure people feel safe to attend.

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