LAUSR

Abstract Background Moderate worry about cancer, defined as a negative emotional reaction to the threat of cancer, in general facilitates uptake of cancer screening, but some studies suggest that specific worries about potential consequences of cancer (eg, cancer treatments or dying) may act as deterrents. However, no studies have examined these associations in the same sample. We aimed to assess the impact of general versus specific cancer worries on cancer screening attendance. Methods We analysed data from a population-based survey of 2048 English adults (18–70 years, median 43 [IQR 30–58], 1098 [54%] female) using home-based, computer-assisted personal interviewing delivered via the TNS Omnibus survey tool. Cancer worries were measured with one item about the frequency of general cancer worry, and two subscales of six specific cancer worry items relating to cancer treatments and death, and to the social consequences of a cancer diagnosis (including its impact on identity, sexuality, important relationships, and finances). All items were adapted from a validated scale. Using logistic regression analysis, we examined the association between these three types of cancer worry and self-reported screening attendance (regular vs never or irregular) among participants eligible for cervical (n=673), breast (323), and bowel cancer (369) screening. Previous studies show that self-reported uptake is a reliable measure of actual attendance. All participants gave verbal informed consent. Ethics approval was given by University College London Research Ethics Committee (5771/002). Findings Regular screening attendance was reported by 74·7% (n=503), 82·0% (265), and 65·9% (243) of participants for cervical, breast, and bowel cancer screening, respectively. General cancer worry was not associated with screening attendance. Worries about the social consequences of a cancer diagnosis, but not about treatment and death, were associated with a lower likelihood of regular attendance for cervical screening (odds ratio 0·77, 95% CI 0·61–0·96; p=0·021) and breast screening (0·63, 0·43–0·92; p=0·016). By contrast, worries about treatment and death, but not social consequences, were associated with higher odds of regular uptake of bowel screening (1·47, 1·10–1·96; p=0·009). Interpretation Specific worries about cancer can affect attendance differently across screening programmes. Interventions to increase informed participation in screening could target the specific worries shown to deter participation in each programme. Funding Supported by a programme grant from Cancer Research UK programme grant (C1418/A14134). Cancer Research UK was not involved in the design of this study; collection, analysis, or interpretation of the results; the writing of the abstract; or the decision to submit for publication.