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Socioeconomic differences in cancer screening participation: comparing cognitive and psychosocial explanations

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  • Wardle, Jane
  • McCaffery, Kirsten
  • Nadel, Marion
  • Atkin, Wendy

Abstract

This paper compares psychosocial and cognitive models of socioeconomic variation in participation in screening for colorectal cancer. The psychosocial model suggests that factors such as higher stress and lower social support explain, in part, why people from lower socioeconomic status (SES) environments are less likely to participate in screening. The cognitive model suggests that beliefs about cancer risk and screening will play an important part in differential participation. In practice both sets of factors may contribute to explaining socioeconomic differentials. The data for these analyses are drawn from a randomised controlled trial of colorectal cancer screening (the UK Flexible Sigmoidoscopy Trial). The participants are from the Scottish centre, where recruitment was stratified to generate a socioeconomically diverse sample. The dependent variable was interest in attending screening. A questionnaire covering demographic status, psychosocial and cognitive factors as well as interest in screening was sent to 10,650 adults. The results showed the predicted SES gradient in interest. There were also SES differences in both psychosocial and cognitive variables. A series of logistic regression models were used to test potential mediators of the association between SES and interest in attending screening by successively including psychosocial factors, cognitive factors, and then both, in the equation. Only the inclusion of the cognitive variables significantly reduced the variation associated with SES, providing better support for the cognitive than the psychosocial model.

Suggested Citation

  • Wardle, Jane & McCaffery, Kirsten & Nadel, Marion & Atkin, Wendy, 2004. "Socioeconomic differences in cancer screening participation: comparing cognitive and psychosocial explanations," Social Science & Medicine, Elsevier, vol. 59(2), pages 249-261, July.
  • Handle: RePEc:eee:socmed:v:59:y:2004:i:2:p:249-261
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    Citations

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    Cited by:

    1. Minh Vu & Kees van Gool & Elizabeth Savage & Marion Haas & Stephen Birch, 2008. "Breast screening in NSW, Australia: predictors of non-attendance and irregular attendance," Working Papers 2008/6, CHERE, University of Technology, Sydney.
    2. Lisa Zumpe & Tobias Bensel & Andreas Wienke & Matilda Mtaya-Mlangwa & Jeremias Hey, 2021. "The Oral Health Situation of 12-Year-Old School Children in the Rural Region of Ilembula in Southwestern Tanzania: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(22), pages 1-11, November.
    3. Ming Chen & Huiyun Zhu & Yiqi Du & Geliang Yang, 2018. "How does the social environment during life course embody in and influence the development of cancer?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(7), pages 811-821, September.
    4. Anne Starker & Franziska Prütz & Susanne Jordan, 2021. "Intention for Screening Colonoscopy among Previous Non-Participants: Results of a Representative Cross-Sectional Study in Germany," IJERPH, MDPI, vol. 18(8), pages 1-13, April.
    5. Peretti-Watel, Patrick & Raude, Jocelyn & Sagaon-Teyssier, Luis & Constant, Aymery & Verger, Pierre & Beck, François, 2014. "Attitudes toward vaccination and the H1N1 vaccine: Poor people's unfounded fears or legitimate concerns of the elite?," Social Science & Medicine, Elsevier, vol. 109(C), pages 10-18.

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