Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research

Young, Ben; Bedford, Laura; Kendrick, Denise; Vedhara, Kavita; Robertson, John; das Nair, Roshan

Abstract

Background: This review aimed to better understand experiences of being invited to cancer screening and associated decision-making.
Methods: Qualitative evidence explaining UK cancer screening attendance decisions was systematically identified. Data were extracted and meta-ethnography used to identify shared themes, synthesise findings and generate higher level interpretations.
Results: Thirty four studies met inclusion criteria. They related to uptake of breast, cervical, colorectal, prostate, ovarian and lung cancer screening. Three primary themes emerged from the synthesis. Relationships with the health service shaped decisions, influenced by trust, compliance with power, resistance to control or surveillance, and perceived failures to meet cultural, religious and language needs. Fear of cancer screening was both a motivator and barrier in different ways and to varying degrees. Strategies to negotiate moderate fear levels were evident. Experiences of risk included the creation of alternative personal risk discourses and the use of screening as a coping strategy, influenced by disease beliefs and feelings of health and wellness.
Conclusions: The findings highlight the importance of the provider-patient relationship in screening uptake and enrich our understanding of how fear and risk are experienced and negotiated. This knowledge can help promote uptake and improve the effectiveness of cancer screening.

Citation

Young, B., Bedford, L., Kendrick, D., Vedhara, K., Robertson, J., & das Nair, R. (in press). Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research. Journal of Public Health, https://doi.org/10.1093/pubmed/fdx026

• Journal Article Type: Article
• Acceptance Date: Feb 24, 2017
• Online Publication Date: May 9, 2017
• Deposit Date: Apr 26, 2017
• Publicly Available Date: May 9, 2017
• Journal: Journal of Public Health
• Print ISSN: 1741-3842
• Electronic ISSN: 1741-3850
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1093/pubmed/fdx026
• Keywords: Cancer screening; screening uptake; screening barriers; qualitative review; meta-synthesis; meta-ethnography; cancer fear; patient-practitioner relationship.
• Public URL: https://nottingham-repository.worktribe.com/output/860156
• Publisher URL: https://academic.oup.com/jpubhealth/article-lookup/doi/10.1093/pubmed/fdx026
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Public Health following peer review. The version of record B. Young, L. Bedford, D. Kendrick, K. Vedhara, J.F.R. Robertson, R. das Nair; Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research. J Public Health (Oxf) 2017 1-25. is available online at: https://doi.org/10.1093/pubmed/fdx026
• Contract Date: Apr 26, 2017