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Introduction: Multicancer detection tests (MCDs) are blood-based tests designed to detect multiple cancer types. It is currently unclear whether these cancer screening tests improve mortality. To understand awareness of MCDs among providers and patients, as well as explore how they perceive the benefits, harms, and acceptability of MCDs, we have undertaken a focus group study in primary care physicians (PCPs) and laypersons to explore knowledge, attitudes, and expectations of cancer screening using MCDs., Methods: We conducted six focus groups with 45 PCP participants and 12 focus groups with 80 layperson participants. Participants were identified via a consumer research firm and found eligible following the completion of a screener survey. Moderators used a semi-structured guide containing open-ended questions and prompts to facilitate the discussion. Recordings were transcribed and coded line by line using a codebook developed based on questions and emerging discussion concepts, and emergent themes were identified., Results: Both PCP and layperson participants felt the that benefits of MCDs included ease of use and potential ability to detect cancers early. However, they felt that additional data is needed to overcome some of the concerns related to MCDs. PCP participants expressed concerns related to lack of practice guidelines, cost of diagnostic follow-ups, privacy and insurance issues, fear/anxiety related to confirmation of MCD results, and malpractice liability related to perceived false negative test results. Layperson participants expressed concerns related to costs, insurance coverage, and privacy, as well as anxiety over the confirmation of a positive test result., Conclusions: There is a major need for more rigorous data regarding MCDs to inform the development of guidelines for use as cancer screening tools., (Published 2024. This article is a U.S. Government work and is in the public domain in the USA. Cancer Medicine published by John Wiley & Sons Ltd.)

Purpose: Increasing the perceived need for CRC screening can facilitate undertaking CRC screening. This study aims to identify factors associated with the need for CRC screening in rural populations., Design: A cross-sectional online survey., Setting: The survey was conducted in June - September 2022 in the rural areas of Alaska, Idaho, Oregon, and Washington, US., Subjects: The subjects of this study were 250 adults (completion rate: 65%) aged 45-75 residing in rural Alaska, Idaho, Oregon, and Washington., Measures: Perceived need for CRC screening, internet usage for health purposes, demographics, and intrapersonal, interpersonal, community, and environmental characteristics., Results: Perceived need for CRC screening were negatively associated with patient-provider miscommunication ( β = -.23, P < .001) and perceived discrimination ( β = -.21, P < .001), cancer fatalism (β = -.16, P < .05), individualism ( β = -.15, P < .05), and dependence on community ( β = -.11, P < .05), but positively with compliance with social norms ( β = .16, P < .05), trust in health care providers ( β = .16, P < .05), knowledge about colorectal cancer ( β = .12, P < .05)., Conclusions: Our study showed potential individual and situational characteristics that might help increase colorectal cancer screening. Future efforts might consider addressing discrimination in health care settings, improving patient-provider communication, and tailoring messaging to reflect the rural culture., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Understanding the relationship between fear of gynecological cancer and awareness of cancer in women may help oncology nurses increase women's participation in gynecological cancer screening., Objective: To examine the relationship between women's gynecological cancer awareness and cancer fear using social media and the affecting factors., Methods: In a descriptive and cross-sectional study design, online data were collected from 1231 women aged 20 to 69 years through social media using the Descriptive Information Form, the Gynecological Cancer Awareness Scale (GCAS), and the Cancer Worry Scale (CWS). Analytic tests included paired t tests, analysis of variance, and post hoc correlations and structural equation modeling., Results: The women's total mean GCAS score was above moderate (152 ± 17), and their mean CWS score was high (19 ± 5). There was no relationship between the GCAS and CWS mean scores. Characteristics of participants with high awareness of gynecological cancer were being young, having a high educational level, having children, living in a province, having a history of cancer or family history of cancer, and having regular gynecological examinations, Papanicolaou smear tests, breast self-examination, and vulva examinations ( P < .05). The fear of cancer was higher in women with children, a family history of cancer, and regular gynecological examination behaviors ( P < .05)., Conclusion: Awareness of gynecological cancer was not significantly statistically associated with fear of cancer. Certain sociodemographic and gynecological characteristics are associated with awareness of gynecological cancer and/or fear of cancer., Implications for Practice: Oncology nurses may plan individualized or large-scale educational events that may make use of social media to enhance accurate awareness of gynecological cancer and related examinations in women., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Despite higher breast cancer screening rates, black women still are more likely to have late-stage disease diagnosed. This disparity is influenced in part by structural and interpersonal racism. This prospective study sought to determine how interpersonal factors, including perceived discrimination, influence screening and stage of disease at diagnosis., Methods: A prospective cohort study analyzed adult women with stages I to IV breast cancer from the Miami Breast Cancer Disparities Study. Perceived discrimination and mistrust of providers were assessed using previously validated questionnaires. Multivariable logistic regression was used to evaluate the odds of screening mammography utilization and late-stage breast cancer at diagnosis., Results: The study enrolled 342 patients (54.4 % Hispanic, 15.8 % white, and 17.3 % black). Multivariate regression, after control for both individual- and neighborhood-level factors, showed that a higher level of perceived discrimination was associated with greater odds of late-stage disease (adjusted odds ratio [aOR], 1.06; range, 1.01-1.12); p = 0.022) and lower odds of screening mammography (aOR, 0.96; range, 0.92-0.99; p = 0.046). A higher level of perceived discrimination also was negatively correlated with multiple measures of provider trust., Discussion: This study identified that high perceived level of discrimination is associated with decreased odds of ever having a screening mammogram and increased odds of late-stage disease. Efforts are needed to reach women who experience perceived discrimination and to improve the patient-provider trust relationship because these may be modifiable risk factors for barriers to screening and late-stage disease presentation, which ultimately have an impact on breast cancer survival., (© 2024. The Author(s).)

Introduction: Cervical cancer is a leading cause of cancer-related mortality in Ethiopia, despite being preventable. Screening programs remain underutilized despite multiple initiatives. This systematic review and meta-analysis aimed to assess the pooled prevalence of intention to undergo cervical cancer screening and its associated factors among Ethiopian women, addressing a significant gap in national data., Methods and Materials: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, HINARI, Google Scholar, and African Journals online were searched using specific keywords and Medical Subject Headings (MeSH). Studies were assessed using a standardized appraisal format adapted from the Newcastle-Ottawa Scale (NOS). Data extraction and analysis were performed using Microsoft Excel-10 and STATA 17 software, respectively. Heterogeneity was evaluated with the I2 statistic and publication bias was examined using Egger's test. Meta-analysis employed a random-effects model., Result: Out of the 750 articles retrieved, nine were included in this systematic review and meta-analysis. The pooled prevalence of intention to screen for cervical cancer in Ethiopia was 33% (95% CI: 9%-56%). Factors significantly associated with intention to undergo cervical cancer screening included favorable attitude (POR = 2.15, 95% CI: 1.29, 4.26), good knowledge about cervical cancer screening (POR: 3.49; 95% CI: 2.04, 6.93), and direct subjective norm (POR: 1.54; 95% CI: 1.32, 3.54)., Conclusion: Based on the findings of this meta-analysis, it was observed that women's intention toward cervical cancer screening was low. Determinants identified included favorable attitude, direct subjective norm, and good knowledge of cervical cancer screening. To enhance women's intention for cervical cancer screening, strategies, and activities should be developed to positively influence perceptions among women and those who influence their decisions. Additionally, efforts to enhance public awareness about cervical cancer and its prevention are crucial., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lahole et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Colorectal cancer (CRC) screening can reduce both CRC incidence and mortality, and faecal immunochemical testing (FIT)-based screening programmes are therefore now being implemented in many countries. However, social inequality in FIT-based screening participation is well documented, and initiatives to address this challenge are understudied. We explored the perceptions of CRC screening and the perceived barriers and facilitators towards FIT-based CRC screening among men visiting a drop-in centre for people with severe social problems in Denmark., Methods: The study was a qualitative interview study. Participants were sixteen men visiting a drop-in centre in Denmark. A local staff member provided supplementary information and assisted with the recruitment process. The interviews were transcribed verbatim, followed by an inductive content analysis., Results: The men were often dealing with health and social problems, and they often had low self-esteem. At first, they stated that they did not think much about cancer and their own risk of being diagnosed with it. They argued that they had little time, energy, and resources to participating in, for example, CRC screening programmes, and barriers to participating were facts of life such as comorbidity and cognitive difficulties. Further, they were not sure how to participate, and some misunderstood the concept of screening. However, during the interviews, the main part of the participants became very keen to participate, and they suggested that in the future, they could receive regular information about cancer screening in face-to-face interactions with someone who cared and was interested in helping them., Conclusion: Men in a vulnerable position visiting a drop-in centre were interested in CRC screening. If we intervene in a way that meets the needs among these vulnerable citizens, it may contribute to reducing social inequality in FIT-based CRC screening programmes., (© 2024. The Author(s).)

Background: The increased knowledge of cervical cancer (CC) risk factors and suboptimal performance of present screening programs has generated interest in shifting from a universal screening approach to one based on individual risk assessment. To inform the future development of risk-based CC screening programs, it is crucial to gain insight into the factors influencing the acceptability of such approach among screening target group women. The aim of this study was to prospectively investigate the acceptability of risk-based CC screening and to identify potential barriers., Methods: In this qualitative study, one-to-one semi-structured interviews were conducted with a purposeful sample including women aged 30-65 years to explore women's perspectives on the acceptability of risk-based CC screening. The study was conducted in Estonia, and interviews were conducted from March to September 2023. Potential participants were approached in person by a member of the study team or by their healthcare providers at primary care or gynaecology clinics. The interview guides were developed based on the concept of acceptability of healthcare interventions., Results: Twenty participants (mean age 44.5, SD = 8.6) with diverse backgrounds were interviewed. The seven components of acceptability (affective attitude, burden, ethicality, opportunity costs, perceived effectiveness, self-efficacy, and intervention coherence) were explored as key themes. Generally, women supported risk-based screening. However, we identified several factors that may compromise the acceptability of risk-based screening. The participants were reluctant to accept less intense screening for low-risk women and anticipated that if risk-based approach was implemented, more frequent testing would remain an option. Providing in-person clinician support was expected, requiring additional healthcare resources. Knowledge gaps in CC prevention highlighted the need for accessible information and education. Most women were unworried about sensitive data inclusion in risk score calculations. However, some participants were concerned about potential confidentiality breaches by healthcare workers., Conclusion: This study indicates that risk-based CC screening is acceptable, except for testing low-risk women less frequently. Our findings underscore the necessity for comprehensive understanding of the needs and concerns of the target group women for program development. Healthcare organizations are required to proactively address these needs by implementing comprehensive information dissemination and efficient communication approaches., (© 2024. The Author(s).)

Background: Breast Cancer remains among the top five cancers responsible for morbidity and mortality globally. For many years, infectious (communicable) diseases were a primary concern in low- and middle-income countries (LMICs) compared to higher-income countries, where non-communicable diseases (NCDs) were already a major concern. However, starting from the early 2000s, the LMICs including Tanzania has witnessed an epidemiological transition being equally affected by NCDs, and breast cancer, is among the prevalent NCDs. While the evidence is vast on the role of breast cancer screening messages in promoting screening, debunking myths, and addressing barriers to the uptake of breast cancer services, context-specific messages are limited. Amidst the changing technology, growth of social media and cultural dynamics, context-specific breast cancer screening messages are needed. We aimed to analyze the breast cancer screening messages from the experiences of women seeking care at Ocean Road Cancer Institute in Tanzania., Methods: An exploratory qualitative case study adopting in-depth interviews (IDI) and focused group discussion (FGD) was carried out among purposefully selected women aged from 18 years to 65 years seeking care from Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Eighteen women participated in the IDIs, and 16 women participated in FGD. Data analysis followed inductive qualitative content analysis., Findings: Three main categories emerged: the existence of multiple sources of breast cancer screening messages, the strengths and weaknesses of breast cancer screening messages, and clients' mixed perceptions of breast cancer screening messages., Conclusion: The findings of this study depict that although breast cancer screening promotion messages are regarded as a source of information about cancers, they fall short of completeness and relevance to the otherwise at-risk population and trigger negative perceptions toward screening. Therefore, this study advocates revisiting the breast cancer screening messages, employing participatory approaches to tailor the screening messages and communication media to fit specific audiences. This calls for re-designing both the content of the messages and means of delivery; thus, collaborative efforts are needed., (© 2024. The Author(s).)

Background: Annual breast magnetic resonance imaging (MRI) is highly recommended to assist mammography for women at high risk of breast cancer (BC). This study explored the knowledge, attitude, and willingness toward breast MRI screening among women at high risk of BC., Methods: This cross-sectional study enrolled women at high risk of BC between August 2022 and January 2023 in Beijing, China. A structural equation model (SEM) was used to analyze the relationships among knowledge, attitude, and willingness., Results: A total of 596 questionnaires were collected, and 412 questionnaires (69.13%) were valid. The women's knowledge and attitude scores were 7.75 ± 2.79 (possible range: 0-12) and 48.53 ± 6.31 (possible range: 13-65). Among the women, 297 (72.09%) were willing to undergo regular breast MRI screening. The SEM showed that knowledge had direct effect on attitude [β = 0.77, 95% CI: (0.57, 0.98), P < 0.001], the attitude had direct effect on willingness [β = 0.02, 95% CI: (0.01, 0.02), P < 0.001], knowledge had an indirect effect on willingness through attitude [β = 0.01, 95% CI: (0.01,0.02), P < 0.001], and the direct effect of knowledge on practice was not significant., Conclusions: The women at high risk of BC had insufficient knowledge and a relatively positive attitude toward breast MRI screening. Most of them were willing to undergo regular breast MRI screening. Advertising and public health education programs should be designed to improve their knowledge and attitude, therefore improving their willingness and practice., (© 2024. The Author(s).)

Background: The increasing incidence of breast cancer and disease burden is a significant public health concern. While 30% of breast cancers could be prevented through addressing modifiable risk factors, misconceptions among women about breast cancer risks hamper primary prevention. In the absence of primary prevention, secondary prevention such as mammography increases the early detection of breast cancer and improves health outcomes. However, current population-level screening rates indicate secondary prevention is suboptimal. More effective public health efforts to improve breast cancer prevention are required. Given breast cancer is socially patterned, this work explores how social class impacts women's breast cancer prevention practices. This study uses the concepts of lay epidemiology and candidacy as a mechanism to understand women's breast cancer risk perspectives. It engages Bourdieu's relational social class theory to unpack how women's social, cultural, and structured life contexts shape these perspectives and their considerations regarding primary and secondary prevention., Methods: In this qualitative study 43 Australian midlife women (aged 45-64 years), were interviewed to explore their understandings of breast cancer risks, how they perceived their own risk, and how this shaped their prevention behaviours. A theory-informed thematic analysis applying Bourdieu's concepts of habitus, capital, and fields to understand how women's social class positions shapes risk perspectives and prevention practices was conducted., Results: This social class analysis showed differences in how women engage in breast cancer discourse, consider risks, and participate in breast cancer prevention. Middle-class women prioritise health promoting practices and were more likely than working-class and affluent women to attend mammography screening. Working-class women experience structural factors, like low income, stress and difficult life circumstances, which hamper primary prevention practices and for some screening is not considered or prioritised, and their decisions not to screen are less active. Affluent women often do not consider themselves at-risk due to their healthier 'lifestyles. 'They suggest that this, and their knowledge of screening benefits and harms allows them to make informed decisions not to screen., Conclusions: Women interpret and understand breast cancer risks differently and enact prevention practices within the parameters afforded by their social class positions. These findings are useful to inform improved public health approaches regarding both modifiable breast cancer risks and increasing mammography screening. To improve equity in breast cancer prevention efforts, such approaches must respond to limitations based on social class and address structural factors that impact prevention practices., (© 2024. The Author(s).)

Background: Cervical cancer is a leading cause of cancer mortality globally, especially in Africa, including Ethiopia. This review assesses predictors of cervical cancer screening uptake among Ethiopian-eligible women using the Health Belief Model. Higher education levels, perceived susceptibility, severity, and fewer barriers are associated with increased screening. Effective HBM-based interventions could enhance screening rates, potentially reducing cervical cancer incidence and mortality., Objective: The review aimed to synthesize the existing literature on the prevalence of Cervical Cancer Screening Service Uptake and Associated Factors among Eligible Women using the Health belief model in Ethiopia, 2024., Method: This systematic review and meta-analysis searched Google Scholar, PubMed, and the Cochrane Library engine. Key terms such as "Cervical cancer screening", "uptake", "utilization", "factors", "barriers", and "Ethiopia" were used to identify relevant articles. Data extraction utilized a detailed form, and the methodological quality of each study was assessed using the JBI quality appraisal checklist for cross-sectional studies. Statistical analysis was conducted using STATA version 17, and the meta-analysis findings were presented using forest plots and tables., Result: The result of seven studies revealed that the overall prevalence of Cervical Cancer Screening Service Uptake among eligible women in Ethiopia was 21% (95% CI: 15%-27%). Factors independently associated with Cancer Screening Service Uptake included: Knowledge (OR = 4.563, 95% CI: 1.012-4.188), age 30 up to 49 (OR = 4.106, 95% CI: 1.562-6.650), history of STD (OR = 2.59, 95% CI: 1.694-4.486), high perceived susceptibility (OR = 3.814, 95% CI: 2.312-5.316), high perceived severity (OR = 2.603, 95% CI: 2.203-3.003), low perceived barrier (OR = 4.390, 95% CI: 1.331-8.449), high perceived self-efficacy (OR = 4.77, 95% CI: 4.102-5.431), high perceived benefit (OR = 3.67, 95% CI: 1.851-5.489), and education level greater than primary level (OR = 4.497, 95% CI: 3.619-5.375)., Conclusion: Cervical cancer is a major public health challenge in Ethiopia. Consequently, there is a pressing need for the governments to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the problem influenced by interconnected factors, to reduce the prevalence of cervical cancer in Ethiopia., (© 2024. The Author(s).)

Aim: To understand young women's views of cervical screening, what obstacles they face, and what encourages them when considering attending their cervical screening., Background: Cervical screening figures have been steadily decreasing in the United Kingdom (UK). There is limited research on this trend, especially around views and knowledge of young women, aged 20-24 years, have before they are eligible for cervical screening., Methods: This qualitative study conducted 15 semi-structured Zoom in-depth interviews to discuss young women's knowledge and perceptions of cervical screening in 2022. Participants were based in the UK. Thematic analysis was used to systematically manage, analyse, and identify themes including cervical screening knowledge; perceptions of cervical screening; barriers to cervical screening; and facilitators of cervical screening., Findings: The findings demonstrate significant gaps in knowledge and negative perceptions of cervical screening. Barriers to attending cervical screening were perceived pain and embarrassment. Facilitators suggested to promote attendance were ensuring access to appointments, creating pop-up clinics, and utilising incentives. The level of knowledge demonstrated by the participants, their negatively framed perceptions; and the vast number of barriers identified present substantial factors that could affect future attendance to cervical screening. Overall, action needs to be taken to prevent decreasing cervical screening attendance rates and eradicate any barriers women may experience.

Objectives: To identify barriers to surveillance mammography adherence in Korean breast cancer survivors (BCSs), which is crucial for early detection of recurrence and new cancers., Sample & Setting: 195 BCSs were recruited from a breast cancer clinic and its support groups at a South Korean hospital., Methods & Variables: This descriptive study used a cross-sectional design. Participants completed a self-administered multi-instrument survey based on a comprehensive framework for adherence, including individual characteristics, symptoms, quality of life, cognitive appraisal, social support, and healthcare system factors., Results: Having had a mammogram within the past year was considered adherent (n = 177), and no mammography within the past year was considered nonadherent (n = 18). Logistic regression revealed that longer time since diagnosis (p < 0.001), greater depression (p = 0.024), and higher health services utilization (p < 0.001) were predictors of lower mammography adherence (chi square = 76.618, p < 0.001, R2 = 58%)., Implications for Nursing: This is the first study to identify depression as a barrier to surveillance mammography in BCSs, suggesting that depression screening and treatment may be important for increasing adherence.

Objectives: The objectives are to investigate the status of knowledge, attitudes and practices (KAP) and to identify factors related to KAP towards breast and cervical cancer screening among rural Chinese women aged 40-65 years., Design and Setting: This cross-sectional study was conducted from July to September 2020 in rural areas of eastern China., Participants: This study involved 301 rural women aged 40-65 years., Variables and Outcomes: The questionnaire included demographic information and the KAP related to breast and cervical cancer screening. Multivariate linear regression analysis was used for the multifactor analysis., Results: A total of 301 rural women aged 40-65 years participated in the survey. The overall score of KAP was (62.41±11.24), and the scores of each KAP domain relating to screening for breast and cervical cancer among participants in rural areas were (1.82±0.97), (44.52±7.20) and (16.06±4.56), respectively. The following factors were significantly associated with the total KAP Score relating to breast and cervical cancer screening among rural women aged 40-65 years, explaining 35% of the variance (p<0.001): aged 50-54 (β = -0.160, 95% CI -7.403 to -0.794), aged 55-59 (β = -0.266, 95% CI -10.763 to -3.757), aged 60-65 (β = -0.243, 95% CI -12.504 to -4.331), junior high school (β = 0.186, 95% CI 1.287 to 7.064), housewife (β = 0.172, 95% CI 0.849 to 6.868), other work (β = 0.171, 95% CI 3.818 to 15.044), annual household income ranging from 50 000 to 79 999 (β = 0.281, 95% CI 3.887 to 10.458) and annual household income≥80 000 (β = 0.330, 95% CI 4.735 to 11.554)., Conclusions: The status of KAP related to breast and cervical cancer screening still requires improvement. Measures to enhance the participation of the two-cancer screening should be provided to rural women aged between 50 and 65 years with lower education level and lower annual household income, especially women who are farmers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: In the United States, colorectal cancer (CRC) is the third leading cause of cancer death among Black men. Compared to men of all other races or ethnicities, Black men have the lowest rates of CRC screening participation, which contributes to later-stage diagnoses and greater mortality. Despite CRC screening being a critical component of early detection and increased survival, few interventions have been tailored for Black men., Objective: This study aims to report on the multistep process used to translate formative research including prior experiences implementing a national CRC education program, community advisory, and preliminary survey results into a culturally tailored mobile health (mHealth) intervention., Methods: A theoretically and empirically informed translational science public health intervention was developed using the Behavioral Design Thinking approach. Data to inform how content should be tailored were collected from the empirical literature and a community advisory board of Black men (n=7) and reinforced by the preliminary results of 98 survey respondents., Results: A community advisory board identified changes for delivery that were private, self-paced, and easily accessible and content that addressed medical mistrust, access delays for referrals and appointments, lack of local information, misinformation, and the role of families. Empirical literature and survey results identified the need for local health clinic involvement as critical to screening uptake, leading to a partnership with local Federally Qualified Health Centers to connect participants directly to clinical care. Men surveyed (n=98) who live or work in the study area were an average of 59 (SD 7.9) years old and held high levels of mistrust of health care institutions. In the last 12 months, 25% (24/98) of them did not see a doctor and 16.3% (16/98) of them did not have a regular doctor. Regarding CRC, 27% (26/98) and 38% (37/98) of them had never had a colonoscopy or blood stool test, respectively., Conclusions: Working with a third-party developer, a prototype mHealth app that is downloadable, optimized for iPhone and Android users, and uses familiar sharing, video, and text messaging modalities was created. Guided by our results, we created 4 short videos (1:30-2 min) including a survivor vignette, animated videos about CRC and the type of screening tests, and a message from a community clinic partner. Men also receive tailored feedback and direct navigation to local Federally Qualified Health Center partners including via school-based family clinics. These content and delivery elements of the mHealth intervention were the direct result of the multipronged, theoretically informed approach to translate an existing but generalized CRC knowledge-based intervention into a digital, self-paced, tailored intervention with links to local community clinics., Trial Registration: ClinicalTrials.gov NCT05980182; https://clinicaltrials.gov/study/NCT05980182., (©Maria D Thomson, Guleer H Shahab, Chelsey A Cooper-McGill, Vanessa B Sheppard, Sherrick S Hill, Michael Preston, Larry Keen II. Originally published in JMIR Formative Research (https://formative.jmir.org), 10.10.2024.)

Background: Reducing exposure to risk factors and screening represent 2 major approaches to gastric cancer (GC) prevention, but public knowledge GC risk factors and screening behaviour remain unknown. We aimed to investigate public awareness of GC risk factors, adherence to screening, and barriers hindering screening practices in China., Methods: This community-based household survey was conducted within Shijiazhuang, China, and 1490 residents were recruited through a multistage stratified cluster random sampling approach. A self-administered questionnaire was completed which consisted of three sections: demographics, awareness of GC risk factors, and personal screening behaviours. Factors associated with knowledge of risk factors and screening behaviours were evaluated using binary logistic regression analysis., Results: The mean risk factor awareness score of 12 (7, 15) revealed insufficient knowledge in 51.1% of participants. Dietary lifestyle factors were better understood than physical activity and weight-related factors. Marital status (OR 1.967; 95% CI 1.415 to 2.734), higher income (OR 1.197; 95% CI 1.010 to 1.418), and a history of upper gastrointestinal problems (OR 0.048; 95% CI 1.002 to 1.311) were associated with higher awareness. Merely 21.5% underwent GC screening, with higher rates linked to older age (OR 1.642; 95% CI 1.418 to 1.902), higher education (OR 1.398; 95% CI 1.176 to 1.662), a history of upper gastrointestinal problems (OR 3.842; 95% CI 2.833 to 5.209), and moderate (OR 2.077; 95% CI 1.352 to 3.191) and high (OR 2.529; 95% CI 1.311 to 4.878) perceived GC risk. Notably, participants commonly refused gastroscopy due to the absence of symptoms or signs., Conclusions: In Shijiazhuang, more than half of participants demonstrated inadequate knowledge of GC risk factors, and screening participation rates were remarkably low. This emphasizes the need for targeted interventions to enhance GC awareness and significantly improve screening rates., Competing Interests: The authors have declared that no competing interest exsist., (Copyright: © 2024 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: The incidence rates of dementia, mild cognitive impairment, and cancer increase with age, posing challenges to affected individuals and their families. However, there are currently no clear cancer screening guidelines for individuals with cognitive impairment. This study analyzed the impact of carer health literacy on screening behaviors in this population., Methods: We conducted a postal follow-up survey, associated with the National Center for Geriatrics and Gerontology-Life STORIES of People with Dementia, that targeted primary carers to assess their reports regarding patient attendance at regular cancer screenings recommended by the Japanese Ministry of Health, Labor and Welfare, over the preceding 2 years. Screening rates were compared between the memory clinic cohort and the national average, and the influence of carer health literacy level on screening was analyzed., Results: Among the 826 total individuals analyzed, the memory clinic cohort exhibited lower breast cancer screening rates, at 11% among female patients aged 65-74 years versus the national average of 32%. Higher health literacy among carers was significantly associated with increased screening. For female patients, carers with high levels of communicative health literacy were more likely to ensure that patients attended screenings for gastric (adjusted odds ratio [AOR], 1.77; 95% confidence interval [CI], 1.03-3.04), colorectal (AOR, 1.70, 95% CI 1.08-2.70), and breast cancers (AOR, 3.08; 95% CI, 1.40-6.76). Among the male patients, high communicative health literacy was associated with increased lung cancer screening attendance (AOR, 1.82; 95% CI, 1.11-2.99)., Conclusions: Our research highlights a notable gap in cancer screening attendance between individuals with cognitive impairment and the general population, potentially arising from the intricate nature of screening procedures and the extensive burden on carers. More informed decisions and increased screening rates can be achieved through patient-centric communication strategies that accommodate the cognitive abilities of patients, ensuring the comprehensibility and accessibility of health-related information., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Background: In Alabama only 4% of those eligible have been screened for lung cancer. The ALCASE project focused on navigating eligible individuals to lung cancer screening., Methods: Trained local staff enrolled screen eligible individuals from seven rural counties and one urban county. Demographics and knowledge of and barriers to lung cancer screening were collected using questionnaires. Education was provided and individuals were navigated to undergo screening. Descriptive statistics for enrolled and screened participants were computed using SAS 9.4. Debriefing interviews were conducted with the ALCASE staff regarding facilitators/barriers to implementing this project and lessons learned. Using NVivo, themes were identified through a combined deductive and inductive process., Results: In total, 447 people were contacted of which 257 were enrolled. Participants were predominantly African American (86.8%), female (56.8%), and 86.4% had health insurance. Study participants acknowledged the need for more education of lung cancer/screening procedures; help navigating clinics for screening services and having healthcare facilities close to home. The top five barriers to getting screened were transportation, financial issues, emotional concerns, healthcare insurance, and COVID-19. Of the 257, 106 participants (41%) completed a primary care referral and were screened for lung cancer. Debriefing interviews revealed: (i) Overall impressions of implementing ALCASE were positive. (ii) Barriers in implementing ALCASE were identified predominantly at the physician and institutional level. (iii) Facilitators in implementing ALCASE were identified at multiple levels. (iv) Suggestions on improving lung cancer screening leaned toward mitigating barriers at the institutional and structural level., Conclusion: Ability to get screened is severely challenged by both personal and structural barriers., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Purpose: To understand key barriers to diagnostic follow-up for women with an abnormal clinical breast examination (CBE) at the primary care level in the Uttar Pradesh state in India. We also explored acceptability of mobile phones to address barriers to CBE follow-up for women., Materials and Methods: We conducted 28 semistructured in-depth interviews with 12 women with an abnormal CBE at the primary health facility who did not have diagnostic follow-up, four community health workers, nine health care providers from health facilities in rural and urban settings, and three state-level decision makers. Interviews were audiorecorded, transcribed verbatim, and translated from Hindi to English. Thematic analysis was conducted using Dedoose qualitative software. Themes were organized by multilevel barriers to follow-up., Results: Key barriers to CBE follow-up included knowledge, fear, and stigma about breast cancer; women's health not being prioritized in the family; discomfort seeing male providers; and difficulty navigating the diagnostic facility. Despite community education and outreach efforts by community health workers (known as Accredited Social Health Activists), lack of awareness of breast cancer and the importance of follow-up for abnormal CBE remains a barrier to early detection. Despite widespread access to mobile phones, perceived acceptability varied among stakeholders regarding mobile phone use for breast health education and communication with clients., Conclusion: Knowledge, cultural, and health system barriers challenge women's ability to follow recommendations for diagnostic follow-up of an abnormal CBE. Multilevel and gender-responsive strategies are needed to address these barriers. Our results suggest that mobile phones could be used to further improve breast health awareness, patient navigation, and tracking, and further research is needed.

Background: Cervical cancer is the fourth most common cancer in women worldwide, and women with human immunodeficiency virus (HIV) are particularly at risk of developing it. Regular screening effectively prevents morbidity and mortality. This mixed-methods study quantitatively assessed cervical cancer screening uptake and qualitatively explored the process of undergoing cervical cancer screening to understand possible reasons for delayed screening among women with HIV in Lesotho., Methods: Between October 2020 and March 2022, the Viral load Triggered ART care in Lesotho (VITAL) trial enrolled women aged 18 years and older with HIV who were taking antiretroviral therapy (ART). Cervical cancer screening delay was defined as reporting a screening that occurred more than two years ago or never having been screened. Cervical cancer screening uptake and the association between screening delay and sociodemographic variables were assessed using a multivariable mixed-effects logistic regression model accounting for clustering at clinic level. In-depth interviews were conducted with 16 women to obtain information on awareness, perceptions, and barriers to cervical cancer screening and were analyzed using thematic analysis., Results: Quantitative data were available for 3790 women. Among them, cervical cancer screening was delayed in 1814 (47.9%), including 1533 (40.5%) who were never screened. Compared to women aged 25 to 39 years, women aged 18 to 24 years (adjusted odds ratio (aOR) 2.8; 95% confidence interval (CI) 2.1-3.7), women aged 40 to 59 years (aOR 1.3; CI 1.1-1.6), and women older than 60 years (aOR 3.9; CI 3.0-5.1) were at higher risk of screening delay. Furthermore, time on ART below 6 months (aOR 1.6; CI 1.1-2.3) compared to above 6 months was associated with screening delay. Qualitative data identified limited awareness of cervical cancer risks and screening guidelines, misconceptions and fears created by the influence of other women's narratives, and low internal motivation as the main barriers to screening uptake., Conclusions: Cervical cancer screening delay was common. Limited personal awareness and motivation as well as the negative influence of other women were the primary internal barriers to cervical cancer screening. Awareness and screening campaigns in Lesotho should consider these factors., Trial Registration: clinicaltrials.gov, NCT04527874, August 27, 2020., (© 2024. The Author(s).)

Objective: Identify barriers and enablers for remote Tasmanians participating in bowel cancer screening through the National Bowel Cancer Screening Program., Setting: A small remote Tasmanian community., Participants: Tasmanian remote community members aged 50 years and over., Design: A qualitative study conducted 16 semi-structured interviews. Two researchers conducted in-person and telephone interviews. Questions were directed by an interview guide developed using the Theoretical Domains Framework for behaviour change and Behaviour Change Wheel. Two researchers analysed data using directed content analysis with a flexible inductive approach., Results: Four themes related to barriers and enablers to completing the National Bowel Cancer Screening Program screening kit in remote Tasmania. Themes included the subject of screening, physical screening kit, the process and outcome of the kit. Several barrier and enabler sub-themes overlapped or were linked, as many enablers mitigated barriers. For example, social influences, awareness level, steps in completing screening, and planning and timing to screen. Social support and discussing screening with others were key enablers, whereas lack of these were barriers. For remote communities, taking the kit to the post office was a barrier from often knowing the post officer. A bowel bus providing screening and information support services may reduce the travel burden of follow-up diagnostic tests and support low-literacy individuals to screen., Conclusion: Barriers and enablers exist within each stage of the screening process, from what influences an individual decision to screen, through to the outcome. To improve screening rates in rural/remote Tasmania, barriers and enablers to screening must be considered., (© 2024 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

The purpose of the present study was to investigate the quality of patient/clinician communication as one potential factor that impacts colorectal cancer screening behavior. As part of a larger randomized controlled trial conducted between 2011 and 2016 in the setting of community and academic family medicine or internal medicine practices in Michigan, USA, patients completed a pre-encounter survey, completed their regularly scheduled visit with their primary care clinician (which was audio-recorded), completed a post-encounter survey, and allowed 6-month follow-up chart audit. We trained 10 coders to rate 216 of the audio-recorded conversations between 216 patients and their primary care physicians for 6 specific features of communication quality (using 7-point scales), including the extent to which participants enacted attention to medical content, engagement, emotional expression, relationships, face, and accommodation. At least 3 coders rated each conversation, and intraclass correlations (i.e., reliability assessment) were in the good to excellent range. We found that patient and clinician attention to face (an identity goal) was a significant predictor of colorectal cancer screening at 6 months follow up. Measuring communication in terms of attention to multiple goals reveals unexpected findings about the aspects of communication that impact colorectal cancer screening behavior. The focus of many interventions to improve colorectal cancer screening rates is on the content (i.e., task goals) of clinicians' communication (such as presenting the different options for screening), yet the content of communication was not a significant predictor of screening in the present study. Rather, clinicians' and patients' attention to identity goals predicted screening behavior, which suggests that interventions may not need to be overly complex and that simply improving the quality of attention to identity goals in clinician communication might be one of the most straightforward yet impactful ways to improve colorectal cancer screening uptake among patients., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Trials assessing the clinical utility of blood-based multi-cancer early detection (MCED) tests are underway. Understanding public attitudes towards MCED screening is essential if these tests are to be used. We aimed to quantify MCED screening intention and potential barriers and facilitators to uptake., Methods: Adults aged 50-77 (n = 958) completed an online survey. The primary outcome was intention to have MCED screening if offered. Psychological variables including barriers and facilitators were assessed. We used logistic regressions to explore associations between socio-demographics and psychological factors and intention., Results: 93.8% of participants said they would 'definitely' or 'probably' have MCED screening if offered. Intention was significantly associated with previous screening participation and general cancer attitudes but not with socio-demographic factors. Participants were more likely to be intenders if they had higher health motivation, and perceived greater benefits of blood tests. Participants were less likely to be intenders if they perceived greater disadvantages of blood tests, more practical barriers, were more worried about the outcome and more concerned about a positive result., Conclusions and Implications: MCED screening intention was high. The lack of socio-demographic variation suggests equitable interest in this type of screening; however, future research should consider how intention translates to uptake., (© 2024. The Author(s).)

Colorectal cancer (CRC) remains the third leading cause of cancer death in the USA. Latinx adults are overrepresented in late-stage CRC diagnosis as CRC screening utilization remains low among Latinx-identifying individuals. This study aims to evaluate the effect of a theory-based narrative video following a culturally appropriate storyline on CRC screening intention, knowledge, and psychosocial variables along the U.S.-Mexico border. We designed and analyzed a non-randomized pre-posttest evaluation of a narrative, culturally tailored video embedded within a community program. The study is set in the U.S.-Mexico border community. Outreach provided a link or QR code to access the survey. In all, 458 participants started the survey, and 304 completed the survey. Participants were recruited through flyers distributed throughout various community events by the program's community health workers and via social media. The intervention evaluated changes in participant's knowledge, perceived barriers, perceived susceptibility, self-efficacy, and perceived benefits and intention to screen. Participants were a mean age of 39 and identified mainly as female (72.7%) and Hispanic/Latinx (88.49%). After viewing the narrative video, participants had significantly improved perceived susceptibility, self-efficacy, and benefits, while perceived barriers and sense of fatalism significantly decreased. Paradoxically, this was associated with a significant decrease in knowledge scores. Results from this intervention suggest that a theory-based narrative video following a culturally appropriate storyline effectively improves psychosocial variables and intention to carry out CRC screening in a predominantly Hispanic border population., (© 2024. The Author(s) under exclusive licence to American Association for Cancer Education.)

Objective: This qualitative descriptive study draws on data collected from a sub-sample of 15 women participating in a national study (n = 60) exploring the breast cancer screening motivations and behaviours of women aged ≥75 years. The study aimed to understand why women living in rural and remote areas might continue accessing mobile breast cancer screening despite being outside the targeted age range., Setting: Settings ranged from large towns to very remote communities (according to Monash Modified Model (MMM) classification 3-7) where BreastScreen Australia mobile screening services were available., Participants: Interview data from 15 women aged ≥75 years living in rural and remote locations who had used mobile screening services was utilised for this study., Design: In-depth individual interviews were conducted via telephone or online platform (Zoom). These were transcribed verbatim and imported into NVivo software to enable thematic analysis to identify key themes., Results: Many women aged ≥75 years in rural and remote areas expressed clear intentions to continue breast cancer screening, despite no longer being invited to do so. They perceived great value in the mobile service and were highly appreciative for it yet acknowledged limited sources of information about the process of ongoing screening., Conclusion: Few women in rural and remote areas had discussed ongoing breast cancer screening with their general practitioner (GP). More information is required to inform women about the risks and benefits of ongoing screening. Without an invitation to attend screening rural women reported difficulty in knowing when the service would be available. Ongoing notification of the availability of mobile services for women aged ≥75 years in rural areas is recommended., (© 2024 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Background: Racism is a social determinant of health inequities and associated with poorer health and health behaviors. As a domain of racism, self-reported racial discrimination affects health through unhealthy behaviors (e.g., smoking) but the understudied impact of self-reported racial discrimination's relationship with healthy behaviors (e.g., cancer screening) precludes a comprehensive understanding of racism's impact on health inequities. Understanding how self-reported racial discrimination impacts healthy behaviors is even more important for those living in rural persistent poverty areas (poverty rates of 20% or more of a population since 1980), who have a higher disease burden due to poverty's interaction with racism. The distinct sociocultural context of rural persistent poverty areas may result in differential responses to self-reported racial discrimination compared to those in non-persistent poverty areas., Methods: A community-engaged process was used to administer a survey to a convenience sample of 251 Black adults residing in 11 rural persistent poverty counties in the state of Arkansas. Self-reported racial discrimination, fruit and vegetable intake, colorectal cancer screening, cervical cancer screening, and screening mammography were assessed. Stress and religion/spirituality were also assessed as potential mediators or moderators in the relationship between self-reported racial discrimination and healthy behaviors., Results: In adjusted models, those reporting more self-reported racial discrimination had a higher probability of having had a test to check for cervical cancer (situation discrimination: OR = 1.23, 95% CI: 1.04-1.5; frequency discrimination: OR = 1.06, 95% CI: 1.02-1.12). Stress and religion/spirituality were not significant mediators/moderators., Discussion: Greater self-reported racial discrimination was associated with a higher odds of cervical cancer screening. Black adults residing in rural persistent poverty areas may have greater self-reported racial discrimination-specific coping and racial identity attitudes., (© 2023. W. Montague Cobb-NMA Health Institute.)

Cancer screening behaviors in Muslims are under-researched, and there is limited data on how it relates to their unique cultural and religious beliefs. We assessed cancer prevention and screening-related health needs in the Washington DC area. We developed the needs assessment questionnaires and recruitment strategy in collaboration with key faith leaders from four mosques in our catchment area. A total of 203 participants were recruited through community outreach and engagement approaches and were included in the discussion when developing the needs assessment to ensure questions were religiously and culturally sensitive. Of the 203 participants, 56% of women reported receiving screening for a mammogram, while 83% of women reported receiving a screening for cervical cancer. Among men, 45% reported receiving a prostate cancer antigen test to screen for prostate cancer. Among both men and women, 35% reported ever receiving a screening for colorectal cancer. Women reported relying more on their faith when dealing with health concerns than men. Those who did not get screened for breast, colorectal, and cervical cancer relied more on their faith than those who did get screened for these cancers. Participants expressed interest in having health initiatives around cancer education, screening, and survivorship inside mosques. Faith beliefs can influence cancer screening behaviors; however, the relationship between these two variables needs further examination. Continued engagement with key faith leaders can help in leveraging religious beliefs to promote health education and cancer screening., (© 2024. The Author(s).)

We explored longitudinal associations between religion/spirituality (R/S) Salience and R/S Attendance, and colorectal cancer screening, among adults aged ≥ 50 years in Alberta, Canada. R/S Salience was not statistically significantly associated with colorectal cancer screening (adjusted odds ratio [aOR]: 1.06, 95% confidence interval [CI] 0.88-1.28). Conversely, R/S Attendance was statistically significantly associated with higher odds of colorectal cancer screening: the aOR was 1.28 (95% CI 1.02-1.59) for participants attending services at least once a month and 1.31 (95% CI 1.01-1.69) for participants attending between one and four times yearly, compared to participants who never attended. Researchers should explore the possibility of delivering colorectal cancer screening programs in R/S settings., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study examined the association among cancer history, social support, and up-to-date colorectal cancer (CRC) screening among four racial/ethnic groups. We conducted a cross-sectional analysis using data on respondents aged 45 to 75 years from the 2022 Behavioral Risk Factor Surveillance System. Our outcome of interest was CRC screening and exposures of interest were race/ethnicity, cancer history, and social support. Weighted multivariable logistic regression was performed. Among 73,869 adults, the CRC screening rate was 66.8% with the highest rate in non-Hispanic (NH), Whites (72.2%), and the lowest in Hispanics (52.6%). Screening rates were higher in adults with a cancer history (81.9%) and those having social support (69%). Hispanic adults with a cancer history had lower screening use (50.9% vs. 77.4% in the no cancer history group; P value < 0.001). Regardless of race/ethnicity, adults without social support had lower screening utilization (P value < 0.05). In effect modification, NH White adults who reported no cancer history and lack of social support were 12% less likely to have CRC screening than those with social support but without cancer history (OR, 0.88; 95% confidence intervals, 0.79-0.98). Similar results were observed among Hispanic adults without a cancer history and social support, with 37% less likely to have CRC screening than those with social support but no cancer history (OR, 0.63; 95% confidence intervals, 0.42-0.93). NH White and Hispanic adults without a cancer history and limited social support were less likely to have CRC screening uptake. By implementing culturally tailored interventions that address social support needs, greater CRC screening compliance may be increased among these populations. Prevention Relevance: Adherence to CRC screening recommendations reduces cancer incidence and mortality. Effective implementation of culturally tailored interventions that address social support needs and consider cancer history have the potential for improving CRC screening compliance among NH White and Hispanic adults without a cancer history., (©2024 American Association for Cancer Research.)

Objectives: This study aimed to analyze the behavioral determinants of breast cancer (BC) diagnosis delays in France. To do so, we investigated whether time discounting, risk tolerance, and personality traits influenced the BC diagnosis delay of patients., Methods: We used original retrospective data collected on 2 large online patient networks from 402 women diagnosed of BC. The BC diagnosis delay was measured by the difference between the date of diagnosis and the date of first symptoms. Time discounting and risk tolerance are measured with both self-reported questions and hypothetical lotteries. Personality traits are measured with the 10-item Big Five indicator. Ordinary least square and probit models were used to analyze whether these behavioral characteristics influenced the BC diagnosis delay., Results: Results showed that risk tolerance and time discounting were not significantly associated with the BC diagnosis delay. However, we found a longer diagnosis delay for women with a neuroticism personality trait (standardized coefficients ranged from 0.104 [P-value = .036] to 0.090 [P-value = .065])., Conclusions: Overall, our findings underline the need for an increased consideration of cancer screening public health policy for women with mental vulnerabilities since such vulnerabilities were found to be highly correlated with a neuroticism personality trait., Competing Interests: Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section., (Copyright © 2024. Published by Elsevier Inc.)

Background: Cervical Cancer is the commonest and one of the leading causes of death from cancer among women in developing countries. Screening has been shown to reduce morbidity and mortality from the illness, yet its uptake is low. This study investigated the pattern of utilization and preferences relating to the adoption of cervical screening among female postgraduate students at the University of Ibadan., Methodology: The study was a descriptive cross-sectional survey involving the use of a multi-stage sampling technique to recruit 372 women undergoing postgraduate studies (20-52 years with a mean age of 27.3 ± 5.4) at the University of Ibadan, Nigeria. A pretested semi-structured, self-administered questionnaire was used for data collection and the coded data were analyzed using SPSS (version 20)., Results: Only 4.0% of the respondents had been screened for Cervical Cancer at the time of study while 86.3% expressed their desire to be screened if given the opportunity. Most participants showed a favourable perception with 70.4% disagreeing that cervical cancer is a mild disease and 50.5% agreeing that the benefits of cervical cancer screening outweigh the stress of the screening procedure. Female doctors (73.2%) topped the list of health professionals' respondents who preferred to conduct the screening. A majority (70.7%) of the respondents preferred these screenings to be done during antenatal clinic visits. There is a significant association (p.value = 0.0007) between cervical cancer screening behaviors and sexual activity among women., Conclusion: Poor utilization of Cervical cancer screening services is seen among Nigerian women undergoing postgraduate studies but a high willingness to utilize the services in the future with consideration to professionals delivering the service and specific locations where it can be obtained. The poor rate of cervical cancer screening from the study depicts the large extent to which cases of this cancer go without being detected till the advanced stages. Rolling out more screening strategies that will explore different service delivery points/preferences as highlighted in the study is needed for larger coverage., (© 2024. The Author(s).)

Background: Colorectal cancer (CRC) screening decision aids can inform patients about CRC screening benefits, costs, and procedures. Patients who receive the decision aid report wanting to share the information with their families and friends. We evaluated a CRC screening decision aid on Hispanic patients' communication to their alters and whether patient-alter communication leads to alters' CRC screening intention., Methods: We conducted a one-arm pre/post study of Hispanic patients and their alters; patients (n = 42) and their alters (n = 19) were recruited from a clinic site in Yakima County, Washington State. Patients viewed a CRC screening decision aid at the clinic site. Survey data from patients and alters were collected via telephone including patients' communication with their alters about CRC screening after viewing the decision aid and alters' intention to be screened for CRC after talking to the patient., Results: Most participants reported sharing CRC information with their alters after viewing the decision aid, and most alters confirmed they had received CRC information from participants (68%). The decision aid was associated with participants' own intention to undergo CRC screening and with alters' intention to be screened for CRC using a fecal occult blood test (p = 0.014) and sigmoidoscopy (p = 0.011)., Conclusions: Patient decision aids have the potential to increase CRC screening behavior beyond the decision aid recipients to their social network., Trial Registration: Trials Registration Number: NCT04444232 "Retrospectively registered.", (© 2024. The Author(s).)

Background: This study aimed to assess the recognition and understanding of breast awareness (BA) among hospital staff, a group considered influential in disseminating information about health. Compared to the traditional approach of breast self-examination (BSE), BA has gained prominence as a concept focused on early detection. The study also explored the effectiveness of an informational leaflet in conveying BA concepts., Methods: We conducted an online, voluntary, and anonymous questionnaire survey at St. Luke's International Hospital in Japan, where approximately 1,000 breast cancer surgeries are performed annually. The survey comprised three sections: pre-leaflet questions, the informational leaflet, and post-leaflet questions., Results: From a pool of 500 completed questionnaires, 499 were deemed suitable for the analysis. Notably, 78% of respondents were unfamiliar with "BA" before the survey. However, 89.1% expressed interest in adopting daily practices for early breast cancer detection. Following the leaflet exposure, 98.4% of respondents claimed to have understood BA, either completely or partially. The leaflet aided 93.2% of these individuals in differentiating between BA and the traditional BSE method. These outcomes remained consistent across various demographic segments such as occupation, age, and experience with breast cancer care., Conclusions: The study underscores a concerning lack of awareness regarding BA among hospital staff within the surveyed institution. This highlights the need to engage medical professionals in promoting BA within the community. The informational leaflet proved effective in enhancing comprehension of BA across diverse groups, indicating its potential as a widely applicable educational tool. The leaflet facilitated the comprehension of BA among respondents across all demographic groups, indicating its potential for widespread utility., (© 2024. The Author(s).)

Objective: To elucidate experiences and coping strategies among adults in the surveillance of indeterminate pulmonary nodules detected with CT in the population-based Swedish CardioPulmonary bioImage Study (SCAPIS)., Design: A qualitative study of conventional content analysis., Settings: The study was conducted at a university hospital in a southern region of Sweden. The SCAPIS setting is similar to the first round of a population-based lung cancer screening programme., Participants: Participants in SCAPIS who had experienced psychosocial consequences of the surveillance were eligible. Participants of both genders, current, former and non-smokers and of different follow-ups in the surveillance were included. Face-to-face semi-structured interviews with 19 participants were performed using an interview guide with open-ended questions. The participants were aged 56-68 years. Nine were women, 6 and 13 were non-smokers and smokers or former smokers, respectively, and all participants had undergone at least one follow-up of the lungs in the surveillance programme., Results: The results depicted an emotional and mental journey for the participants from being distressed when informed about the need of surveillance, and realising their risks of getting sick if they did not take care of their own health, to eventually gathering the strength to cope with the situation, so the surveillance was finally valued with trust and satisfaction. The experiences and coping strategies in the surveillance programme developed a revelation of the value of health consciousness among the participants., Conclusion: The study results demonstrated that a surveillance programme of pulmonary nodules might develop health consciousness among people. Still, some individuals might experience psychosocial consequences of the surveillance of indeterminate nodules. Therefore, healthcare professionals should be facilitated to perform person-centred communication to support individuals under surveillance. Preventive care to engage individuals as partners in the management of their own health should receive more attention and needs to be explored., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background:  The breast cancer burden on the South African healthcare system is severe, with rural South African women often diagnosed at an advanced stage of the disease. South Africa's rural areas are classified as low-resource settings with limited medical services and infrastructure. The impact of breast cancer on rural communities in South Africa requires ongoing research to better understand the severity of this disease among one of the most vulnerable populations., Objectives:  This study aimed to explore the barriers and enablers of breast cancer screening among rural South African women., Method:  An exploratory qualitative study was utilised. A semi-structured interview was conducted with 22 rural South African women. Data were analysed using thematic analysis. This study utilised the care-seeking behaviour theory as its theoretical framework., Results:  Participants identified many barriers to breast cancer screening, including individual affordability, transportation, rural services, infrastructure, health professional behaviour, and the lack of educational materials. Several factors are suggested to enable the screening of breast cancer in rural South Africa, including breast cancer campaigns, health education, the involvement of key stakeholders, and promotional materials., Conclusion:  Despite the many barriers to breast cancer screening among rural South African women, there is still hope in implementing the various promotional tools outlined in this study and ensuring that breast self-examination is an alternative, affordable screening method.Contribution: The purpose of this article is to contribute to the attainment of the Sustainable Development Goal (SDG) 3, which focusses reducing premature mortality from non-communicable diseases, including cancer.

Objective: 'Sludge' refers to administrative burdens or frictions that preclude people from getting what they want or need (eg, duplicative forms, complicated instructions, long waiting times). This mixed methods study evaluated patients' perceptions of sludge in the colorectal cancer (CRC) screening process and some impacts of this sludge., Design: We employed an exploratory sequential mixed methods study design that comprised patient interviews and a patient survey. The interviews informed final survey revisions and captured contextual data about patients' experiences with sludge. Interview transcripts were inductively and deductively analysed to identify overarching themes. The survey quantified sludge, delayed or forgone screenings, screening experience (Net Promoter Score) and health system distrust (Health System Distrust Scale). We used χ 2 or t-tests for univariable comparisons and logistic or linear regressions to evaluate the association between cumulative sludge score and delayed or forgone screenings, screening experience and health system distrust. Results were integrated for interpretation., Setting: Southeastern United States., Participants: Patients who were 45-75 years of age, at average risk for CRC and had either completed or been referred for CRC screening (colonoscopy or stool-based test) within the previous 12 months., Results: 22 interview participants and 255 survey participants completed the study. 38 (15%) survey participants rated their screening experience as poor (Net Promoter Score=0-7 out of 10). The mean (SD) Health System Distrust Scale score was 22.4 (6.3) out of 45 possible points (higher score=greater distrust). Perceptions of sludge in the CRC screening process varied, with long waiting times and burdensome communication being the most common sources (58% and 35% of participants, respectively). Sludge was positively associated with delayed or forgone screenings (OR=1.42, 95% CI 1.28, 1.57, p<0.001), poor screening experience (OR=1.15, 95% CI 1.04, 1.28, p=0.009) and health system distrust (β=0.47, p<0.001). Qualitative findings add descriptive detail about sludge encountered, context to impacts experienced, and illustrate the heavy emotional impact of sludge: ' it just isn't worth it' ., Conclusion: Efforts to reduce sludge in the CRC screening process may improve timely completion of CRC screening, enhance patient experience and restore trust in the health system., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Breast cancer is a major health concern worldwide, especially in Vietnam. This study aimed to explore women's motivation for and factors related to breast cancer screening., Methods: A mixed-methods study was conducted in Danang, Vietnam, using a convergent parallel approach. This study utilized both quantitative and qualitative methods to gather the data. The quantitative approach involved surveys to assess motivation levels and related factors, including demographic information and experience with breast cancer screening. In-depth qualitative interviews were used to gain deeper insights into participants' perspectives and experiences related to breast cancer screening., Results: The average motivation score for breast cancer screening was moderate (3.55 ± 0.55). Ethnicity, regular health check-ups, family history of breast cancer, receiving information about breast cancer, and women's health issues have direct relationships with breast cancer screening motivation. According to the qualitative data, three categories emerged: intrinsic motivation, external motivation/internalization, and amotivation. The individual, and sociocultural environmental factors impacted screening motivation., Conclusions: This study highlights the motivations behind breast cancer screening among women. Healthcare providers could use these findings to improve screening policies and guidelines and encourage more women to undergo regular screening, ultimately reducing the incidence of breast cancer in the community., (© 2024. The Author(s).)

Men of African ancestry suffer disproportionately from prostate cancer (PCa) compared to other racial groups in South Africa. Equally concerning is that black South African men generally present later and with higher stages and grades of the disease than their non-black counterparts. Despite this, a small percentage of black South African men participate in screening practices for PCa. This study sought to explore knowledge and beliefs of black South African PCa survivors, and the potential impact of this on the limited screening uptake within this population group. A hermeneutic phenomenological study design was undertaken. The sample comprised 20 black South African PCa survivors, between the ages of 67 and 85 years (mean age = 76 yrs; SD = 5.3), receiving some form of treatment at a tertiary Academic Hospital, Limpopo Province, South Africa. The sample was selected through a purposive sampling method. Data for the study were collected through in-depth, semi-structured individual interviews and analyzed through interpretative phenomenological analysis (IPA). The findings demonstrated that black South African men had poor knowledge of PCa and that this may create an unfortunate system that precludes this population group from taking part in life-saving PCa screening services. The results highlight a need to elevate knowledge and awareness of PCa among black South African men and ultimately enhance screening practices.

Background: Cervical cancer continues to threaten women's health, especially in low-resource settings. Regular follow-up after screening and treatment is an effective strategy for monitoring treatment outcomes. Consequently, understanding the factors contributing to patient non-attendance of scheduled follow-up visits is vital to providing high-quality care, reducing morbidity and mortality, and unnecessary healthcare costs in low-resource settings., Methods: A descriptive qualitative study was done among healthcare providers and patients who attended the cervical cancer screening clinic at Mbarara Regional Referral Hospital in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analysed in line with the social-ecological model to identify barriers and facilitators., Results: We conducted 23 in-depth interviews with 5 healthcare providers and 18 patients. Health system barriers included long waiting time at the facility, long turnaround time for laboratory results, congestion and lack of privacy affecting counselling, and healthcare provider training gaps. The most important interpersonal barrier among married women was lacking support from male partners. Individual-level barriers were lack of money for transport, fear of painful procedures, emotional distress, and illiteracy. Inadequate and inaccurate information was a cross-cutting barrier across the individual, interpersonal, and community levels of the socio-ecological model. The facilitators were social support, positive self-perception, and patient counselling., Conclusions: Our study revealed barriers to retention in care after cervical cancer screening, including lack of partner support, financial and educational constraints, and inadequate information. It also found facilitators that included social support, positive self-perception, and effective counselling., (© 2024. The Author(s).)

Intimate partner violence affects 20-30% of women in the United States. Disparities in routine cervical cancer surveillance have been demonstrated in certain populations, including victims of intimate partner violence (IPV). This study examined and assessed the acceptability of high-risk HPV (hrHPV) self-collection among individuals who have experienced IPV. We conducted an observational study using qualitative data collection and analysis. We interviewed individuals with a history of IPV and who currently reside in Oregon. This study identified key themes describing knowledge and attitudes towards cervical cancer screening for individuals who have experienced IPV. They include: guideline knowledge, prior office-based cervical cancer screening experience, barriers to cervical cancer screening, at-home hrHPV self-collection experience, and testing confidence. Participants experienced fewer barriers and expressed increased comfort and control with hrHPV self-collection process. Individuals with a history of IPV have lower rates of cervical cancer screening adherence and higher rates of cervical dysplasia and cancer than other populations. The patient-centered approach of hrHPV self-collection for cervical cancer screening can reduce barriers related to the pelvic exam and empower patients to reduce their risks of developing cervical cancer by enabling greater control of the testing process., (© 2024. The Author(s).)

Early detection decreases deaths from breast cancer. Yet, there are conflicting recommendations about screening mammography by major professional medical organizations, including the age and frequency with which women should be screened. The controversy over breast cancer screening is centered on 3 main points: the impact on mortality, overdiagnosis, and false positive results. Some studies claim that adverse psychological effects such as anxiety or distress are caused by screening mammography. The purpose of this article is to address negative breast cancer screening concerns including overdiagnosis and overtreatment, effect on mortality, false positive results, mammography-related anxiety, and fear of radiation., (© Society of Breast Imaging 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Several rural public health facilities in East Central Uganda have sub-optimal, below 50%, levels of uptake of cervical cancer screening services among women with HIV. This is attributed to low cervical cancer screening literacy: limited ability to access, understand, appraise, and apply cervical cancer screening information. This research identified multi-level (health facility, community, interpersonal and individual) barriers, and facilitators of accessing, understanding, and applying cervical cancer screening information among rural women with HIV attending rural public health facilities in East Central Uganda to inform interventions., Methods: We conducted ten Focus Group Discussions with rural women aged 25-49 years with HIV attending four selected rural public health facilities: thirty women who had ever screened for cervical cancer and thirty women who had never screened for cervical cancer across different age categories. Data was collected using a guide based on the Integrated model of health literacy. Thematic analysis was used for analysis. Competences (accessing, understanding and applying cervical cancer screening information) and categories of factors (health system, community, interpersonal and individual factors) of the integrated model of health literacy were deductively derived whereas barriers and facilitators were deductively derived from women's statements., Results: Lack of communication materials and inability to access information were health facility and individual barriers of accessing cervical cancer screening information respectively. Facilitators of accessing information were access to information at health facility, community, and interpersonal levels and women's ability to access information. Barriers and facilitators of understanding cervical cancer information were related to communication materials, provision of health education and women's concentration during health education. Barriers and facilitators of applying cervical cancer screening information were related to communication and provision of cervical cancer screening services at health facility level, and interpersonal level from peers, partners and other family members as well as women's ability to: understand information and access to cervical cancer screening services at individual level., Conclusions: This study emphasizes the influence of multi-level factors on cervical cancer screening literacy among rural women with HIV attending rural public health facilities in East Central Uganda. Improving uptake of cervical cancer screening services among these women requires multi-level interventions., (© 2024. The Author(s).)

Background: Risk-stratified approaches to breast screening show promise for increasing benefits and reducing harms. But the successful implementation of such an approach will rely on public acceptability. To date, research suggests that while increased screening for women at high risk will be acceptable, any de-intensification of screening for low-risk groups may be met with less enthusiasm. We report findings from a population-based survey of women in England, approaching the age of eligibility for breast screening, to compare the acceptability of current age-based screening with two hypothetical risk-adapted approaches for women at low risk of breast cancer., Methods: An online survey of 1,579 women aged 40-49 with no personal experience of breast cancer or mammography. Participants were recruited via a market research panel, using target quotas for educational attainment and ethnic group, and were randomised to view information about (1) standard NHS age-based screening; (2) a later screening start age for low-risk women; or (3) a longer screening interval for low-risk women. Primary outcomes were cognitive, emotional, and global acceptability. ANOVAs and multiple regression were used to compare acceptability between groups and explore demographic and psychosocial factors associated with acceptability., Results: All three screening approaches were judged to be acceptable on the single-item measure of global acceptability (mean score > 3 on a 5-point scale). Scores for all three measures of acceptability were significantly lower for the risk-adapted scenarios than for age-based screening. There were no differences between the two risk-adapted scenarios. In multivariable analysis, higher breast cancer knowledge was positively associated with cognitive and emotional acceptability of screening approach. Willingness to undergo personal risk assessment was not associated with experimental group., Conclusion: We found no difference in the acceptability of later start age vs. longer screening intervals for women at low risk of breast cancer in a large sample of women who were screening naïve. Although acceptability of both risk-adapted scenarios was lower than for standard age-based screening, overall acceptability was reasonable. The positive associations between knowledge and both cognitive and emotional acceptability suggests clear and reassuring communication about the rationale for de-intensified screening may enhance acceptability., (© 2024. The Author(s).)

Background: Breast cancer is the second most commonly diagnosed cancer worldwide, with a high mortality rate in developing countries, including sub-Saharan Africa. Screening is one way to ensure early detection and management of breast cancer, and it is influenced by several factors. Education and socio-economic status may also affect the utilization of breast cancer screening services as these impact decision-making. This study aimed to investigate women's empowerment and its influence on the uptake of breast cancer screening among women in Tanzania., Methods: This study utilized the 2022 Tanzania Demographic and Health Survey data, and included 4216 women aged 20 to 49 years. Women empowerment variables used include social independence, decision-making, ownership of assets, and attitude towards violence. Statistical Package for Social Sciences version 26 was used for data cleaning and analysis. Descriptive statistics and bivariate analysis were done, including a multivariate logistic regression to assess the level of association between independent variables with breast cancer screening., Results: Findings indicate that the prevalence of breast cancer screening is 5.2%. Age, education level, literacy, ownership of assets, attitude towards violence, and decision making are associated with ever going for breast cancer screening. Women aged 45 to 49 years (AOR = 6.28, 95% CI = 6.27-6.28), those with secondary or higher education (AOR 1.1, 95% CI = 1.05-1.06), literate women (AOR = 1.13, 95% CI = 1.13-1.13), those who own a house (AOR = 3.08, 95% CI = 3.08-3.09), who jointly decide on their healthcare with partners on healthcare (AOR = 1.18, 95% CI = 1.18-1.19) had significantly higher odds of going for breast cancer screening., Conclusion: Women's empowerment is significantly associated with the likelihood of engaging in breast cancer screening. Empowered women are more likely to undergo screening. Focus should be on empowering women through education, businesses, and community involvement. Country-specific interventions and breast cancer screening awareness campaigns should include empowerment initiatives to promote screening uptake., (© 2024. The Author(s).)

Background: Colorectal cancer (CRC) is globally the third most prevalent cancer and a leading cause of cancer-related deaths. In Alberta, Canada, a significant portion of CRC diagnoses occur following emergency department (ED) presentations. Gaps remain in understanding patient's perspectives on CRC diagnosis after an ED visit. The aim of this study was to examine the experiences and perspectives of a group of patients diagnosed with CRC subsequent to an ED visit in Alberta and their close contacts., Methods: We conducted a qualitative study using in-depth, semi-structured interviews with patients diagnosed with CRC after an ED visit at the Rockyview General Hospital, Calgary, and their close contacts, from November 2022 to June 2023. Interviews focused on symptom recognition, healthcare interactions, and the decision-making process leading to an ED visit. They were conducted in-person or over the phone, and analysed using thematic analysis., Results: Eighteen participants (12 patients and 6 close contacts) were interviewed, revealing four main themes: (1) variability in symptom recognition and interpretation; (2) inconsistencies in primary care consultations; (3) factors influencing decision-making leading to an ED visit; and (4) recommendations for expedited diagnosis outside of EDs., Conclusion: The findings highlight the complexity of the diagnostic journey for CRC patients in Alberta, pointing to significant gaps in symptom recognition and response by patients and healthcare providers. Improved diagnostic protocols and targeted support for healthcare providers, as well as approaches to address systemic delays may help streamline the diagnostic journey. Future research should focus on exploring innovative interventions to address the identified barriers to timely CRC diagnosis., (© 2024. The Author(s).)

Purpose: Cancer predisposition syndrome (CPS) surveillance allows for the early detection and treatment of neoplasms; however, the psychosocial impact of tumor surveillance is poorly understood for cancer-affected adolescents with CPS and their parents. To gain further insight, we qualitatively characterized the affective and cognitive experience of adolescents undergoing tumor surveillance., Experimental Design: Adolescents with a history of cancer and their parents independently completed semistructured interviews querying their experience with the adolescent's tumor surveillance. Interviews were coded using emotion coding and content analysis before developing themes using thematic analysis., Results: Eight adolescents and 11 parents (seven mothers, four fathers) completed interviews. Parent themes included maternal anxiety, relief following surveillance, fathers' positive expectations and emotions surrounding surveillance results, coping strategies, and perception of going through surveillance together with their child. Adolescent themes included normalization of surveillance, indifference about surveillance but excitement to return to the hospital, focus on physical and logistic aspects, relief focused on being done with scans, and belief that outcomes would be good. Past scans/surveillance experiences influencing surveillance feelings were a theme across both parents and adolescents., Conclusions: Our findings suggest that tumor surveillance is not causing marked emotional distress for cancer-affected adolescents with CPS. In contrast, mothers of cancer-affected adolescents undergoing surveillance may present with anxiety leading up to tumor surveillance and, for a subset, in between surveillance appointments. These observations highlight a need for ongoing psychosocial screening for families of children with CPS and a role for psychosocial providers in the multidisciplinary management of CPS., (©2024 American Association for Cancer Research.)

Background: The National Cancer Institute Cancer Screening Research Network is launching a pilot study (Vanguard) to determine feasibility of successful completion of a clinical trial of multicancer detection tests. This focus group study reports perceptions of primary care physicians and laypersons of different clinical trial designs and willingness to participate in a multicancer detection clinical trial., Methods: We undertook 14 focus groups with 88 laypersons and 6 focus groups with 45 primary care physicians. Participants were shown graphics of clinical trial designs and asked for their reactions. Focus group recordings were transcribed verbatim, and thematic analysis of the transcripts were conducted to identify emergent themes., Results: Primary care physician and layperson participants recognized the importance of conducting clinical trials to determine the clinical utility of multicancer detection tests. Primary care physicians expressed reluctance to participate in trials because of workload burden, and laypersons expressed hesitancy about enrolling in the control group. Primary care physicians and laypersons expressed concern about a study design in which multicancer detection test results would not be returned to the control group (intended effect), but they respectively indicated a willingness to refer patients to, or participate in, a multicancer detection test clinical trial given transparent and clear communication on collection and use of biospecimens and data, particularly if a multicancer detection test would eventually be run and results eventually returned., Conclusion: This study yielded important insights to guide trial design in planning prospective evaluation of multicancer detection testing. Maintaining transparency and trust while possibly withholding multicancer detection test results to maximize trial feasibility and efficiency is of particular concern., (Published by Oxford University Press 2024.)

Background: Cervical cancer-related stigma is common but understudied in the Caribbean. This study aims to describe the age difference of cervical cancer stigma and to evaluate the influence on the prevention practices among the Caribbean nonpatient population in Jamaica, Grenada, and Trinidad and Tobago., Methods: A cross-sectional study involving 1209 participants was conducted using a culturally trans-created Cancer Stigma Scale for the Caribbean context and supplemented with questions on cervical cancer and human papillomavirus (HPV) and HPV vaccine knowledge and beliefs. Descriptive analyses and χ2 tests were conducted., Results: The χ2 tests showed age is statistically significantly related to participants' response to stigma items such as "community members believe cervical cancer is viewed as shameful" (P = .0001); "women with cervical cancer are treated with less respect than usual by others" (P < .0001); "women with cervical cancer are rejected by family members" (P = .0007); "women with cervical cancer are rejected by intimate partners" (P < .0001); and "intimate partners blame women for having cervical cancer" (P = .0032). Additionally, age has statistically significant associations with endorsements of negative views of cervical cancer from the community (P < .0001) and family (P < .0001) as key barriers to cervical cancer care (item: "discourage women from seeking and obtaining screening and treatment"). Notably, younger respondents (18-25 years) are more sensitized to the unfair stigma and hold more stigma., Conclusions: Among Caribbeans, age influences cervical cancer stigma. Younger persons acknowledged greater stigma within families and communities. This study can guide age-informed interventions and programs to reduce stigma and improve cervical cancer screening and care seeking to reduce cervical cancer burden and disparities., (© The Author(s) 2024. Published by Oxford University Press.)

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States. Surveillance colonoscopy is recommended 1-year after surgical resection for patients with stage I-III CRC; however, only 18%-61% of CRC survivors complete this test. This study describes clinician-identified barriers and facilitators to surveillance colonoscopy among CRC survivors., Methods: We conducted semi-structured interviews with clinicians until thematic saturation was achieved. Interviews were analyzed using the social cognitive theory., Results: Thirteen clinicians were interviewed, and all identified health system-level barriers to surveillance colonoscopy completion; the most common being fragmented care due to patients receiving care across many health systems. Clinicians also identified social determinants of health barriers (e.g., geographical distance between patients and health systems) to 1-year surveillance colonoscopy completion., Conclusions: Clinicians identified several potentially modifiable barriers to 1-year surveillance colonoscopy completion which, if addressed, could improve post-treatment care and outcomes among stage I-III CRC survivors., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Background: This cross-sectional study explored how masculinity beliefs may influence colorectal cancer (CRC) screening participation among ethnic subgroups of screening-age-eligible (45-75 years) Hispanic/Latino men., Methods: Using a consumer panel, we recruited self-identified Hispanic/Latino men fluent in English or Spanish, and residing in Florida, New York, or Texas. The Masculinity Barriers to Medical Care (MBMC) scale and its six subscales were used to assess masculinity beliefs. Multivariable logistic regression was used to estimate the association between MBMC and CRC screening participation, adjusting for Hispanic/Latino subgroup, marital status, survey language, age group, and health insurance status. Results were then stratified by Hispanic/Latino subgroup., Results: Of the participants (n=611), approximately 31% identified as Puerto Rican, 30% as other Hispanic/Latino, 26% as Mexican, and 14% as Cuban; 63% had ever been screened for CRC. We found no differences in the prevalence of screening participation by Hispanic/Latino subgroup. The majority of participants had completed both a stool-based test and an exam-based screening test (29.3%). After adjusting for confounding, MBMC reduced the odds of screening participation. Slight MBMC-subscale differences were observed by Hispanic/Latino subgroup. For example, higher scores on the Restrictive Emotionality subscale were associated with a lower likelihood of screening participation among Puerto Rican men, but higher odds of screening for Cuban men., Conclusions: Masculinity barriers to CRC screening may exist. Tailored interventions to address masculinity barriers among specific Latino subgroups may improve CRC screening uptake in this population., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)