THE INFLUENCE OF CANCER ANXIETY ON EVALUATIONS OF GOOD AND POOR QUALITY SCREENING TESTS

Purpose: Considerable research has shown that cancer anxiety is associated with more positive attitudes towards cancer screening tests. However, few studies have established a causal relationship between cancer anxiety and cancer screening acceptance by experimentally varying cancer anxiety. The purpose of this study was to determine whether exposure to anxiety-provoking skin cancer photos increases interest in a hypothetical screening test for skin cancer, and whether the effect of cancer anxiety is similar for screening tests described as being effective versus ineffective.

Method: 1,196 participants (mean age=35.62, SD=11.22, range=18-72, 83.7% white, 51.6% female) completed an online survey. Participants were randomly assigned to view either anxiety-provoking skin cancer photos or healthy skin photos, while they read about different types of skin cancer. Next, participants were randomly assigned to read information about a hypothetical skin-cancer screening test described as either ineffective (e.g., saved no lives and posed a chance of false positives), or effective (e.g., saved lives and posed a relatively low chance of false positives). Participants then rated the likelihood that they would get the screening test, their perceptions of test riskiness, and three cancer anxiety questions (alpha=.912) on 1-9 Likert scales.

Result: The graphic photos caused participants to report more cancer anxiety (M=6.19, SD=2.03) than the healthy photos (M=5.71, SD=2.20, p<.001), and anxiety was significantly associated with screening test acceptance (r=.215, p<.001). Participants were more likely to want the effective test than the ineffective test (F(1,1187)=77.54, p<.001), but the graphic photo conditions did not have a direct effect on test acceptance, p=.836. Instead, a 2-way interaction emerged between test effectiveness and photo conditions (F(1,1187)=5.39, p=.020), such that screening acceptance between the effective and the ineffective tests was more similar in the graphic photos conditions (M_diff=.953, p<.001), than in the healthy photos conditions (M_diff=1.635, p<.001). Perceived test riskiness showed similar results; the 2-way interaction between test effectiveness and photo conditions (F(1,1188)=6.397, p=.012) revealed that the graphic photos made participants rate the effective and ineffective tests as more similar in risk (M_diff=.181, p=.360), than healthy photos (M_diff=.888, p<.001). 

Conclusion: Experimentally varied cancer anxiety did not straightforwardly increase interest in screening. Instead, anxiety appeared to blunt the influence of the objective test information, such that higher anxiety caused the effective and ineffective tests to be judged more similarly.