People who have problems with numbers may be more likely to feel
negative about bowel cancer screening, including fearing an abnormal
result, while some think the test is disgusting or embarrassing,
according to a Cancer Research UK supported study published in the Journal of Health Psychology.
The researchers sent information about bowel cancer screening to
patients aged from 45 to 59 along with a questionnaire which assessed
their numerical skills and attitudes to the screening test, which looks
for blood in stool samples.
Almost 965 people -- registered with four GP practices in the North
of England - returned the questionnaire which asked: 'Which of the
following numbers represents the biggest risk of getting a disease: 1 in
100, 1 in 1000, 1 in 10'. Nearly half (46 per cent) got this question
wrong.
These people, considered to have low numeracy skills, were also more
negative about the bowel cancer screening test, and these attitudes made
them less inclined to take part in screening than those who got the
question right.
They were more likely to think taking the test was disgusting,
embarrassing or 'tempting fate', and to be more afraid of an abnormal
result. They also tended to know less about bowel cancer and were more
likely to avoid or ignore cancer information, even when other factors
such as education and ethnicity were taken into account.
Lead study author Dr Samuel Smith, based at Queen Mary University of
London, said: "People's comprehension of numbers may have links with how
well they understand and use information about bowel cancer screening.
Our findings could help to improve how we discuss screening with the
public. That might be through targeted campaigns in deprived areas where
low numeracy and literacy skills are more common, or through health
workers discussing screening with people who might be inclined to ignore
written information or think they don't need to take a screening test.
"More research is needed but changes to the test itself, that make it
quicker and easier to use, might also help to increase the number of
people with low numeracy skills who take part in screening, by reducing
barriers such as disgust or embarrassment."
Those with low numeracy skills were more likely to have a defensive
attitude to cancer information, such as saying they did not need
screening because their bowel movements were regular, they ate
healthily, or their GP had not told them that the test was important.
The study was part of a project which aims to find ways of getting
more people, whoever and wherever they are, to consider using the bowel
cancer screening test when it's offered to them. Researchers say that
using results from the study to specifically target those with low
numeracy skills could help to achieve this.
Around 41,600 people in the UK are diagnosed with bowel cancer each
year and around 16,200 die from the disease. It is estimated that bowel
screening could save more than 2,000 lives per year in the UK by 2025.
The national screening programme, called faecal occult blood testing
(FOBT), allows the disease to be detected before symptoms become
apparent. It is offered to people aged 60 -- 74 in England, Wales and
Northern Ireland, and 50 -- 74 in Scotland, all of whom are sent a stool
testing kit every two years.
Sara Hiom, director of early diagnosis at Cancer Research UK, said:
"It really is worth using this little kit when you're sent it, even if
you do feel a bit uncomfortable about it. The test can pick up early
stage disease in people who are otherwise fit and healthy, even before
you develop symptoms. Detecting bowel cancer at an early stage means
treatment is more likely to be straightforward and successful, so it's
well worth a bit of extra effort to take the test when you're sent it in
the post.
"This study adds to our knowledge of why some people don't take part
in screening, and could help us to come up with new ways of helping
people overcome these barriers and protect their health."
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