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Reasons for intending to accept or decline kidney cancer screening: thematic analysis of free text from an online survey.

Accepted version
Peer-reviewed

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Authors

Freer-Smith, Charlotte 
Harvey-Kelly, Laragh 
Mills, Katie 
Harrison, Hannah 
Rossi, Sabrina H 

Abstract

OBJECTIVES: Kidney cancer has been identified as a disease for which screening might provide significant benefit for patients. The aim of this study was to understand in detail the facilitators and barriers towards uptake of a future kidney cancer screening programme, and to compare these across four proposed screening modalities. DESIGN: An online survey including free-text responses. SETTING: UK PARTICIPANTS: 668 adults PRIMARY AND SECONDARY OUTCOME MEASURES: The survey assessed participants' self-reported intention to take-up kidney cancer screening with four different test methods (urine test, blood test, ultrasound scan and low-dose CT). We conducted thematic analysis of 2559 free-text comments made within the survey using an inductive approach. RESULTS: We identified five overarching themes that influenced screening intention: 'personal health beliefs', 'practicalities', 'opinions of the test', 'attitudes towards screening' and 'cancer apprehension'. Overall, participants considered the tests presented as simple to complete and the benefits of early detection to outweigh any drawbacks to screening. Dominant facilitators and barriers varied with patterns of intention to take up screening across the four tests. Most intended to take up screening by all four tests, and for these participants, screening was seen as a positive health behaviour. A significant minority were driven by practicalities and the risks of the tests offered. A smaller proportion intended to reject all forms of screening offered, often due to fear or worry about results and unnecessary medical intervention or a general negative view of screening. CONCLUSIONS: Most individuals would accept kidney cancer screening by any of the four test options presented because of strong positive attitudes towards screening in general and the perceived simplicity of the tests. Providing information about the rationale for screening in general and the potential benefits of early detection will be important to optimise uptake among uncertain individuals.

Description

Keywords

kidney tumours, preventive medicine, public health, qualitative research, Adult, Early Detection of Cancer, Humans, Kidney, Kidney Neoplasms, Mass Screening, Surveys and Questionnaires

Journal Title

BMJ Open

Conference Name

Journal ISSN

2044-6055
2044-6055

Volume Title

11

Publisher

BMJ

Rights

All rights reserved
Sponsorship
Cancer Research UK (21464)
MRC (MC_UU_00006/6)
Cancer Research UK (A25117)
This work was funded by a research grant from Kidney Cancer UK (no award number). JUS and KM were supported by a Cancer Research UK Cancer Prevention Fellowship (C55650/A21464). SHR is supported by The Urology Foundation (no award number) and a Cancer Research UK Clinical Research Fellowship (no award number). GDS is funded by the Cancer Research UK Cambridge Cancer Centre (Major Centre Award A25117) and the Renal Cancer Research Fund (no award number). HH is supported by a National Institute of Health Research Methods Fellowship (RM-SR-2017-09-009). The University of Cam-bridge has received salary support in respect of SJG from the NHS in the East of England through the Clinical Academic Reserve.
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