February 16, 2023 – Many people, including 20% of Americans aged 50 to 75don't take part in colon cancer screenings – although there are do-it-yourself tests that assist you to easily and privately take a sample at home.
One possible explanation: Many people persuade themselves that they don’t need it.
Psychologists call this “defensive information processing” – adopting beliefs to scale back fear of a threat. And new research in the journal Cancer suggests that this will likely be a significant reason why some people don't attend advisable colorectal cancer screening tests.
The researchers surveyed 2,600 people in Ireland who had been invited several years previously to take a stool test at home to screen for colon cancer.
Compared to check takers who refused the test, those that refused the test performed higher on defensive behavior, resembling avoidance, denial, believing there was no risk of colon cancer, or arguing against the evidence for the test.
Individuals were particularly unlikely to finish the stool test in the event that they scored high on two behaviors:
- They deny the urgency of testing. They assumed they might wait until they'd less to do or until one other, higher test was available.
- Self-exemption, meaning they assumed they didn't need a test because they'd regular bowel movements, maintained a healthy lifestyle, or ate loads of vegetables.
“These arguments are based on a lack of knowledge about how colon cancer develops,” says study creator Nicholas Clarke, PhD, a postdoctoral fellow in psychology at Dublin City University in Ireland. “It can take 10 years for a person to show signs or symptoms of colon cancer.”
When symptoms appear, the disease is usually already at a sophisticated stage where treatment is tougher. according to CDCNearly 88% of adults diagnosed with early-stage colon cancer live five years or more, compared with only 16% of those diagnosed with late-stage cancer.
In this study, participants received an invite to be screened by mail. In a special context, different defensive reactions might occur. For example, within the U.S., if a health care provider brings up the subject of screening, “participants may be more likely to counterargue or opt out,” Clarke says. “We need to do more research in this area to understand how defensive reactions may differ depending on the context in which the test is offered.”
A social component also plays a task. The study found that folks from economically poorer areas were more defensive and fewer prone to attend preventive medical examinations.
“To improve participation rates in colorectal cancer screening, we need to conduct further research and develop evidence-based interventions that address these inequalities,” says Clarke.
This is particularly necessary for men, as they usually tend to develop colon cancer than women but are less prone to take part in screening, Clarke says.
So what are you able to do should you spontaneously refuse a test?
“I think if a person receives an invitation to a screening and initially reacts negatively or thinks, 'No, I'm not doing that' or 'I don't need that,' they should think about why they reacted that way,” says Clarke. “If a person recognizes that, it would be useful to look for trusted information, such as the American Cancer Society or Irish Cancer Society websites.” Talking to your doctor can allow you to make the correct selection for you.
We can even do more as a society to spread the word. That means raising public awareness about colon cancer, the way it develops and the way long an individual can suffer from it without symptoms, says Clarke. “I think if people knew the course of the disease, they would be less skeptical about being asked to get screened.”