Public understanding of the purpose of cancer screening: A population-based survey

Objectives In examining informed choice in cancer screening, we investigated public awareness that some screening programmes aim to prevent cancer, while others seek to detect cancer at an early stage. Methods A population-based survey of adults aged 50–70 in England (n = 1433), including data on demographic characteristics and screening experience. Participants were asked to select the main purpose of cervical, breast, and colorectal cancer screening (both faecal occult blood testing and flexible sigmoidoscopy). Results Across all four screening programmes, most people thought the main aim was to catch cancer early (71–78%). Only 18 and 14% knew that cervical screening and flexible sigmoidoscopy, respectively, are primarily preventive. Knowledge of the preventive aspect of these two programmes was low across the board, with few demographic patterns. By contrast, 78 and 73% of the sample were aware that breast screening and the faecal occult blood test, respectively, predominantly aim to detect cancer early. For these programmes, accurate knowledge was socially graded, lower in ethnic minority groups, and positively associated with previous participation in the programmes. Conclusions Our findings suggest that although awareness of the purpose of early detection screening is high, awareness that screening can prevent cancer is low across all demographic groups. Understanding the purpose of screening is a key aspect of informed choice but despite current communication strategies highlighting these differences, people do not seem to have a nuanced understanding of these differing aims. Our findings may be indicative of a broader public scepticism about the preventability of cancer

Cancer worry frequency vs. intensity and self-reported colorectal cancer screening uptake: A population-based study.

OBJECTIVES: Many studies of cancer worry use items measuring frequency or intensity. Little is known about how each of these relate to cancer screening uptake. This study compared the association between worry frequency vs. intensity and colorectal cancer screening intention/uptake. METHODS: Across four surveys (2014-2016), we collected data from 2878 screening-eligible men and women (aged 60-70) in England. Measures included single-items assessing cancer worry frequency and intensity, and a derived combination of both. We also assessed self-reported past faecal occult blood testing uptake (ever vs. never), intention to participate when next invited (yes vs. no), and demographics. Using logistic regression, we compared a model containing sociodemographic characteristics (Model 1), with four models adding cancer worry frequency (Model 2), intensity (Model 3), both (Model 4), or the combined measure (Model 5). RESULTS: A model with cancer worry intensity and demographics (Model 3) explained significantly more variance in uptake and intention ( R2 = 0.068 and 0.062, respectively) than demographics alone (Model 1: R2 = 0.058 and 0.042; p < 0.001), or a model with demographics and cancer worry frequency (Model 2: R2 = 0.059 and 0.052; p < 0.001). The model was also equally as effective as models including both the frequency and intensity items (Model 4: R2 = 0.070 n.s. and 0.062 n.s.), or using the derived combination of both (Model 5: R2 = 0.063 n.s. and 0.053 n.s.). CONCLUSION: A single item measure of cancer worry intensity appeared to be most parsimonious for explaining variance in colorectal cancer screening intention and uptake.This work was supported by Cancer Research UK (grant number C1418/A14134)

Food purchasing and preparation patterns by gender during the COVID-19 lockdown in Chilean workers/Patrones de compra y preparación de alimentos según género durante la cuarentena por COVID-19 en trabajadores chilenos

The COVID-19 pandemic has increased the demands that workers face regarding household food-related tasks, such as grocery shopping and cooking. The literature shows that there are differences in these demands by gender, but also based on other sociodemographic characteristics, such as schooling level. The aim of this study was to compare food purchasing and preparation patterns by gender in Chilean workers, before the COVID-19 lockdown and during the first six weeks of lockdown. The study was cross-sectional, and data was collected for the first wave of a multi-country study in April 2020. The sample was composed of 317 participants who were employed during lockdown (67.8% women, mean age of 38.14). Participants answered sociodemographic questions and reported their food purchasing and preparing practices before and during lockdown. Analysis of comparison of proportions was used. On average, during lockdown, men increased their involvement in grocery shopping while women cooked more. Overall, female workers have turned to food-related tasks more often during the pandemic than male workers. This study shows the extent to which workers have changed their degree of involvement in food-related tasks, accounting for conditions such as gender roles, schooling level and working from home. These findings can inform interventions and policies that reinforce advantageous changes brought on by lockdown measures (e.g., home-cooking) to contribute to workers’ and their families’ food-related well-being during and in the aftermath of the pandemic

Determinants of willingness to receive healthy lifestyle advice in the context of cancer screening

Background: Providing lifestyle advice at cancer screening may help reduce the cancer burden attributable to health-related behaviour. We examined determinants of willingness to receive advice about several behavioural cancer risk factors. Methods: A population-based sample of English adults eligible for cancer screening (n = 1221) completed items on willingness to receive lifestyle advice. Sociodemographic, psychological (risk perceptions, cancer risk factor awareness) and behavioural factors were used to predict interest in advice about diet, weight, physical activity, smoking and alcohol consumption. Results: Two thirds (62–67%) reported interest in advice about diet, weight, and physical activity; 17% were willing to receive advice about smoking, and 32% about alcohol consumption. Willingness to receive advice was higher in those not adhering to guidelines for weight, physical activity, smoking and alcohol consumption (all p < 0.01). Non-White ethnicity was associated with interest in advice about diet, physical activity and smoking (all p < 0.01). Willingness to receive advice about diet, weight, physical activity and alcohol consumption increased with greater recognition of cancer risk factors (all p < 0.01). Conclusions: Willingness to receive lifestyle advice at cancer screening was high, suggesting this context may provide an opportunity to support behaviour change. Increasing awareness of cancer risk factors may facilitate interest in lifestyle advice

Impact of COVID-19 lockdown on smoking (waterpipe and cigarette) and participants' BMI across various sociodemographic groups in Arab countries in the Mediterranean Region

INTRODUCTION: Tobacco smokers are at high risk of developing severe COVID-19. Lockdown was a chosen strategy to deal with the spread of infectious diseases; nonetheless, it influenced people's eating and smoking behaviors. The main objective of this study is to determine the impact of the COVID-19 lockdown on smoking (waterpipe and cigarette) behavior and its associations with sociodemographic characteristics and body mass index. METHODS: The data were derived from a large-scale retrospective cross-sectional study using a validated online international survey from 38 countries (n=37207) conducted between 17 April and 25 June 2020. The Eastern Mediterranean Region (WHO-EMR countries) data related to 10 Arabic countries that participated in this survey have been selected for analysis in this study. A total of 12433 participants were included in the analysis of this study, reporting their smoking behavior and their BMI before and during the COVID-19 lockdown. Descriptive and regression analyses were conducted to examine the association between smoking practices and the participant's country of origin, sociodemographic characteristics, and BMI (kg/m2). RESULTS: Overall, the prevalence rate of smoking decreased significantly during the lockdown from 29.8% to 23.5% (p<0.05). The percentage of females who smoke was higher than males among the studied population. The highest smoking prevalence was found in Lebanon (33.2%), and the lowest was in Oman (7.9%). In Egypt, Kuwait, Lebanon, and Saudi Arabia, the data showed a significant difference in the education level of smokers before and during the lockdown (p<0.05). Smokers in Lebanon had lower education levels than those in other countries, where the majority of smokers had a Bachelor's degree. The findings show that the BMI rates in Jordan, Lebanon, Oman, and Saudi Arabia significantly increased during the lockdown (p<0.05). The highest percentages of obesity among smokers before the lockdown were in Oman (33.3%), followed by Bahrain (28.4%) and Qatar (26.4%), whereas, during the lockdown, the percentage of obese smokers was highest in Bahrain (32.1%) followed by Qatar (31.3%) and Oman (25%). According to the logistic regression model, the odds ratio of smoking increased during the pandemic, whereas the odds ratio of TV watching decreased. This finding was statistically significant by age, gender, education level, country of residence, and work status. CONCLUSIONS: Although the overall rates of smoking among the studied countries decreased during the lockdown period, we cannot attribute this change in smoking behavior to the lockdown. Smoking cessation services need to anticipate that unexpected disruptions, such as pandemic lockdowns, may be associated with changes in daily tobacco consumption. Public health authorities should promote the adoption of healthy lifestyles to reduce the long-term negative effects of the lockdown

Meat and masculinities. Can differences in masculinity predict meat consumption, intentions to reduce meat and attitudes towards vegetarians?

"Real men eat meat." While this idea is on the one hand widespread throughout time and cultures, it has also been criticized as being too stereotypical, not applicable to all men alike, and being dependent on group level cultural beliefs about gender norms. Increasingly some men question male norms and male privileges, and value authenticity, domesticity and holistic self-awareness. They identify themselves with 'new' forms of masculinity. This study investigates on an individual level if attachment to these newer forms of masculinity can predict differences in meat consumption, willingness to reduce meat, and attitudes towards vegetarians among men. A total of N = 309 male meat-eating participants were surveyed about their self-identification with new forms of masculinity, their attachment to meat, willingness to reduce their meat intake, and attitudes towards vegetarians. Results show that, as was predicted, men who identify more strongly with new forms of masculinity consume less meat, have a weaker attachment to meat, have a greater tendency to reduce their meat intake, and have more positive attitudes towards vegetarians. In sum this study carefully suggests to not only take biological sex differences, but socially and culturally determined gender differences into account when studying or promoting the (non-)consumption of meat.status: publishe