Understanding intentions and action in colorectal cancer screening

Background Factors involved in forming intentions to attend cancer screening may be different from those involved in translating intentions into action. Purpose To test the hypotheses that social cognition variables predict intention better than action, and that life difficulty variables predict action better than intention, in colorectal screening. Methods Participants from one center in the UK Flexible Sigmoidoscopy Trial (n=2,969) were categorized according to their screening intention, measured at baseline, and their subsequent attendance at screening (recorded at the clinic). Differences in factors related to life difficulty (socioeconomic deprivation, health, stress, social support) and social cognition variables were examined, and discriminant analysis was used to identify sets of variables that best differentiated the groups. Results Social cognition variables were strongly associated with intention but only weakly with action. In contrast, factors related to life difficulties (socioeconomic deprivation, poor health status) were better predictors of action than intention. Conclusions Social cognition variables appeared to be important determinants of screening intentions. Other variables-that may be markers of barriers to implementing plans-were more strongly associated with action. To maximize colorectal screening participation, research is needed to identify a wider range of determinants of attendance.