Interest in Cancer Screening Tests That Lack Benefits: The Role of Cancer Worry, Perceived Cancer Risk, and Perceived Test Risk

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Principal investigator:

Laura Scherer

The University of Misourri

Email: schererl@missouri.edu

Homepage: https://psychology.missouri.edu/people/scherer


Abstract

Research that has explored public enthusiasm for cancer screening has suggested that the public may be overly enthusiastic about being screened with certain tests, and this has been attributed, in part, to lack of knowledge about the risks and benefits. In this study we considered the possibility that some people may be enthusiastic about screening even when they are informed and also accept that the test unquestionably does not save lives. In this study, all participants were asked whether they would want to receive a hypothetical screening test for breast (women) or prostate (men) cancer that does not reduce the chance of cancer death or extend the length of life. Over half of participants wanted to receive the described screening test. Many people did not believe that cancer screening might not save lives, yet screening preferences were not due to disbelief alone. Results further suggested that cancer worry and a desire for health information explained variance in preferences for unbeneficial screening, adjusting for beliefs about screening benefits, perceptions of screening risks, family history, perceptions of cancer risk, and demographics.

Hypotheses

Hypothesis/Research Questions:

Research question 1: What proportion of U.S. adults at screening relevant ages would want a screening test that does not save lives or extend the length of life?

Research question 2: Why do some individuals want screening that does not save lives?

H1: A manipulation that influences perceived risk and cancer anxiety will influence desire for screening; individuals led to believe that their cancer risk is low will be less likely to want the test than individuals led to believe that their risk is high.

H2: Explicitly stating serious possible harms (vs. not) will decrease interest in screening

Experimental Manipulations

Perceived cancer risk/Cancer anxiety: Participants were given an ostensible cancer risk calculator and were given randomized feedback telling them that their cancer risk was either higher or lower than average

Outcome Variables:

Primary: Interest in receiving the described screening test Manipulation checks / other outcomes: Cancer anxiety, perceived cancer risk, belief that screening test does not save lives

Summary of Results

51% of participants wanted to receive the described test when the harms were not described in detail; 34% wanted the test when the harms were presented. The perceived cancer risk manipulation did not influence desire for the test and had only a minimal influence on perceived cancer risk and cancer anxiety. Many participants did not believe that the test did not save lives (which was what they were told), but of participants who did believe what they were told about the test, 43% when the harms were not described, and 23% wanted the test when the harms were described. Significant predictors of desire for screening included cancer worry, perceptions of test risks and benefits, and having relatives diagnosed with breast/prostate cancer.

References

Scherer, L.D., Valentine, K.D., Patel, N., & Baker, S.G., Fagerlin, A. (in press). A Bias for Action in Cancer Screening? Journal of Experimental Psychology: Applied.