INTEREST IN CANCER SCREENING TESTS THAT LACK BENEFITS

Purpose: There is growing concern that screening tests for some cancers have fewer benefits and more risks than what was initially believed. Nonetheless, rates of screening remain high for low-yield tests, and studies have shown that many people are interested in screening even after being informed of the risks and low benefit. In the present research, we tested the limits of individuals’ desire for screening. Specifically, we examined interest in a hypothetical cancer screening test that unambiguously has no benefits whatsoever.

Method:

Participants (N=303) completed an online survey in which they were asked to consider getting screened for breast cancer (women) or prostate cancer (men). Participant age ranged from 18-69 (M=37.66, SD=13.436). Participants were randomly assigned to consider one of three different tests. In one condition, the test was described as standard mammography or PSA. In another condition, the test was described as an alternative to these standard tests that has been used for 30 years. In a third condition, the test was described as being new. Critically, in all conditions participants were told that “research has shown that the test has absolutely no benefits in terms of saving lives,” because of the high rate of false positives, false negatives, and overdiagnosis.

Result:

Across all conditions, 61.1% of participants wanted to get the screening test. Approximately half of the sample maintained beliefs that the test had benefits. Of the participants who accepted that the test had no benefits and would not reduce their chance of dying from cancer, 44.7% still wanted to get the test. Participants were just as willing to accept the alternative and new tests as the standard mammography/PSA (all ps>.05). An exploratory logistic regression revealed 4 significant predictors of test acceptance: Participants were less likely to get the test if they felt it was risky, and were more likely to get the test if they believed it had benefits, had high cancer anxiety, or felt it was risky to not get screened (all p<.025). 

Conclusion: A surprising number of participants wanted to get a screening test that had no benefits. Even of people who accepted that the test had no benefits, almost half wanted the test. Regression results indicate that affective feelings are a primary driver of interest in ineffective tests.