Interest in Cancer Screening Tests That Lack Benefits
K.D. Valentine MS, and Laura Scherer PhD; University of Missouri
OSF registration page: osf.io/qu7ev
Current State of
Screening
• Screening tests for breast and prostate
cancer have fewer benefits and more
risks than initially believed.
• Rates of screening remain high, and
many people are interested in screening
even after being told of the new
USPSTF guidelines.
Inclusion Criteria
High Test Uptake Overall and for Those
Assuming No Benefit
• A surprising number of participants
wanted to get a screening test that had no
benefits.
• Even among those who assumed no
benefits, almost half wanted the test.
• Feelings of benefit differ in women,
while feelings of risk differ for both men
and women.
• Regression results indicate that affective
feelings are a primary driver of interest
in ineffective tests.
• Must be at least18 years old (N = 311),
have completed the survey ( N = 303),
and answered our attention check
question correctly (N = 285).
• This desire may be driven by preexisting
Age
beliefs about tests and familiarity.
Participant
Characteristics
Range 18-69
Mean (SD) 37.66 (13.44)
Study Objectives
Gender
• Determine the proportion of participants
who are interested in a screening test
without benefits
• Identify any differences between frames
and genders
• Explore which individual differences
may predict test uptake
Conditions
Test Frame
Gender
New
Test
Breast
Cancer
54
Prostate 45
Cancer
Old
Test
52
43
Standard
Test
50
41
Methods
• Participants (N=311) recruited from
Amazon Mechanical Turk.
• All conditions were told “research
has unquestionably shown that the
test does not reduce the chance of
death from this cancer,” due to the
high rate of false positives, false
negatives, and overdiagnosis.
Limitations
Female 54.7%
Race
White/ European American
Black/African American
Hispanic/Latino(a)
Asian or Pacific Islander
Other/mixed race
80.4%
7.4%
3.5%
6.2%
2.5%
Education
Less than high school
High school only
Some college/trade school
Bachelor’s/Associate’s degree
Master’s degree or more
1.4%
6.6%
30.9%
48.4%
12.7%
Belief in Lack of
Benefits
Conclusions
• Study sample was not a representative
sample of the population
• Dealt with a hypothetical scenario rather
than a real-world decision
• Alternatives such as active surveillance
were not discussed
Future Research
Exploratory Logistic Regression:
Risks, Benefits Predict Uptake in 84.6%
Measure
How risky the test seems
B
.334
S.E.
.113
Wald
8.720
p
.003
Exp(B)
1.396
How beneficial the test seems
-.530
.152
12.190
.000
.589
Assumed no benefit
-1.358
.399
11.579
.001
.257
Risk of not screening
-.615
.144
18.174
.000
.541
Constant
5.989
2.191
7.471
.006
399.025
Analysis also included the following: Berlin numeracy test, Medical maximizer scale, beliefs
about screening test benefit, previously screened for cancer, aware of screening controversy,
family member with cancer, affected by family with cancer, cancer anxiety, perceived likelihood
of developing cancer, perceived severity of cancer diagnosis, belief that scientists are biased.
• Addressing the issue of sampling by
gaining a representative sample of the
U.S.
• Inclusion of an anxiety manipulation
• Presenting information about
alternatives within the framework of the
no benefit test
Acknowledgments
• Participants
• Funding: University of Missouri Startup
Funds allocated to Laura Scherer
• University of Missouri Department of
Psychological Sciences