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Factors influencing the decision to attend screening

Understanding the thought process of patients considering screening tests, following cancer diagnosis will improve take-up rates, studies find. 

It is predicted that 50% of people born since 1960 in the UK will have a cancer diagnosis. Early detection is important yet uptake of free screening tests is not optimum with rates for breast, cervical and colorectal cancer at 71%, 73% and 52%, respectively in England. 

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Understanding the decision-making of those invited for cancer screening is important for health professionals to improve the uptake rate. This review of qualitative research evidence used techniques of meta-ethnography to analyse 34 published studies. 

The studies investigated decisions to attend screening for breast, cervical, colorectal, prostate, ovarian and lung cancer. The meta-analysis identified three overarching themes.

The first was 'relationships with the health service' reflecting the degree of trust in the NHS and health professionals (particularly those in general practice), willingness or resistance to perceived control and surveillance as well as perceived failures to meet cultural (particularly for women) and language needs.

The second was ‘fear of cancer screening’. Four key sources of fear were screening invitations, the threat of cancer in the absence of screening, the threat of abnormal test results and screening methods.

The third theme was ‘experiences of risk'. This included the creation of different personal levels of risk influenced by disease beliefs and feelings of health and wellness.

The authors argue that this evidence can be used by health professionals to help promote the uptake of cancer screening.


Young B, Bedford L, Kendrick D et al (2017) Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research. Journal of Public Health. doi: 10.1093/pubmed/fdx026.

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