Defensive Information Processing Key Factor in FIT-Based Screening Refusal

Defensive information processing is a significant barrier to fecal immunochemical test (FIT)–based colorectal cancer screening, according to a study published online ahead of print in Cancer.

A way to ease negative emotions that crop up in the face of a threat, defensive information processing can include avoidance, mental disengagement or “blunting,” acknowledging a risk for others but not oneself, or “suppression,” and arguing against evidence. Researchers investigated defensive information processing in a population-based colorectal cancer screening program that used FIT in Dublin, Ireland.

The study included 2299 people invited to participate in the screening. Although 311 of participants declined to receive colorectal cancer screening, all participants in the study completed questionnaires designed to elicit views of factors shown to be linked with FIT uptake.

“We have previously reported that, in addition to sex and deprivation, stronger fatalistic beliefs, the belief that the test was disgusting or was tempting fate, and disagreement that cancer can be cured (among those younger than 65 years) were associated with lower uptake,” researchers explained. “In the analyses presented here, we explore the potential additional explanatory role for defensive information processing in uptake.”

Greater defensiveness, as reflected in higher scores on defensive information processing domains, was significantly associated with lower FIT uptake after adjusting for sociodemographic factors, according to the study. In particular, 2 suppression subdomains — denying immediacy (screening is not an immediate concern) and self-exemption (screening is not relevant or important for the individual) — independently predicted nonuse of FIT screening.

“Suppressors who deny the immediacy to be screened may be amenable to behavioral interventions that nudge them to be screened,” researchers advised. “Suppressors who self-exempt themselves may require stronger educational and defensiveness-reducing interventions to encourage future screening participation.”

Reference:
Clarke N, Hayes L, McQueen A, et al. The role of defensive information processing in population-based colorectal cancer screening uptake. Cancer. Published online February 6, 2023. doi:10.1002/cncr.34603