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Intentions to participate in cervical and colorectal cancer screening during the COVID-19 pandemic: a mixed-methods study

Wilson, Rebecca ORCID:, Quinn-Scoggins, Harriet ORCID:, Moriarty, Yvonne ORCID:, Hughes, Jacqueline, Goddard, Mark, Cannings-John, Rebecca ORCID:, Whitelock, Victoria, Whitaker, Katriina L., Grozeva, Detelina ORCID:, Townson, Julia ORCID:, Osborne, Kirsty, Smits, Stephanie ORCID:, Robling, Michael ORCID:, Hepburn, Julie, Moore, Graham ORCID:, Gjini, Ardiana, Brain, Kate ORCID: and Waller, Jo 2021. Intentions to participate in cervical and colorectal cancer screening during the COVID-19 pandemic: a mixed-methods study. Preventive Medicine 153 , 106826. 10.1016/j.ypmed.2021.106826

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Worldwide, cancer screening faced significant disruption in 2020 due to the COVID-19 pandemic. If this has led to changes in public attitudes towards screening and reduced intention to participate, there is a risk of long-term adverse impact on cancer outcomes. In this study, we examined previous participation and future intentions to take part in cervical and colorectal cancer (CRC) screening following the first national lockdown in the UK. Overall, 7543 adults were recruited to a cross-sectional online survey in August–September 2020. Logistic regression analyses were used to identify correlates of strong screening intentions among 2319 participants eligible for cervical screening and 2502 eligible for home-based CRC screening. Qualitative interviews were conducted with a sub-sample of 30 participants. Verbatim transcripts were analysed thematically. Of those eligible, 74% of survey participants intended to attend cervical screening and 84% intended to complete home-based CRC screening when next invited. Thirty percent and 19% of the cervical and CRC samples respectively said they were less likely to attend a cancer screening appointment now than before the pandemic. Previous non-participation was the strongest predictor of low intentions for cervical (aOR 26.31, 95% CI: 17.61–39.30) and CRC (aOR 67.68, 95% CI: 33.91–135.06) screening. Interview participants expressed concerns about visiting healthcare settings but were keen to participate when screening programmes resumed. Intentions to participate in future screening were high and strongly associated with previous engagement in both programmes. As screening services recover, it will be important to monitor participation and to ensure people feel safe to attend.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Centre for Trials Research (CNTRR)
Social Sciences (Includes Criminology and Education)
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Additional Information: This is an open access article under the CC BY license (
Publisher: Elsevier
ISSN: 0091-7435
Funders: ESRC
Date of First Compliant Deposit: 28 September 2021
Date of Acceptance: 26 September 2021
Last Modified: 11 Oct 2023 18:25

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