Institute of Epidemiology & Health Care


Claire Stevens: Cancer Screening as a Teachable Moment for Risk Reduction Behaviour

This thesis explored whether cancer screening participation (breast, bowel, cervical, lung) could be a prompt for spontaneous behaviour change, or an opportunity to deliver behavioural cancer prevention interventions. A systematic review found limited support for breast, bowel, cervical and lung screening as a prompt for spontaneous behaviour change (Study 1). Study 2, in a sample (n=774) of screening-naïve men from the English Longitudinal Study of Ageing, found data indicating that Faecal Occult Blood Testing (FOBT) participation might prompt small positive changes to vigorous physical activity. Study 3A (n=1,037) found most breast, bowel and cervical screening intenders were willing to receive lifestyle advice in a hypothetical screening scenario, even if results require further investigations. Two-thirds of were willing to receive advice about diet, weight and physical activity (Study 3B; n=1,221). Interest in advice about smoking and alcohol consumption was lower.  In a hypothetical lung screening scenario, most screening intenders were willing to receive lifestyle advice, more so if results require further investigations (Study 4; n=459). Half were interested in advice about smoking cessation. There was also some interest in advice about diet, weight, physical activity and alcohol consumption. A qualitative exploration of openness to receiving lifestyle advice alongside cancer screening was conducted among 30 breast, bowel and cervical screening attendees (Study 5). Receptivity was influenced by individuals’ affective response to cancer screening and how advice would be delivered. Four distinct types of receptivity to advice were identified. This study does not support a ‘one-size-fits-all’ approach to intervention delivery in this setting.

Together, findings from this thesis suggest that in the absence of spontaneous behaviour change, targeted interventions and advice may be welcome in the context of cancer screening.

Claire Stevens: Thesis link