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. 2021 May 18;11(5):e044961.
doi: 10.1136/bmjopen-2020-044961.

Reasons for intending to accept or decline kidney cancer screening: thematic analysis of free text from an online survey

Charlotte Freer-Smith  1 , Laragh Harvey-Kelly  1 , Katie Mills  2 , Hannah Harrison  2 , Sabrina H Rossi  3 , Simon J Griffin  2 , Grant D Stewart  4 , Juliet A Usher-Smith  5
Affiliations

Reasons for intending to accept or decline kidney cancer screening: thematic analysis of free text from an online survey

Charlotte Freer-Smith et al. BMJ Open. .

Abstract

Objectives: Kidney cancer has been identified as a disease for which screening might provide significant benefit for patients. The aim of this study was to understand in detail the facilitators and barriers towards uptake of a future kidney cancer screening programme, and to compare these across four proposed screening modalities.

Design: An online survey including free-text responses.

Setting: UK PARTICIPANTS: 668 adults PRIMARY AND SECONDARY OUTCOME MEASURES: The survey assessed participants' self-reported intention to take-up kidney cancer screening with four different test methods (urine test, blood test, ultrasound scan and low-dose CT). We conducted thematic analysis of 2559 free-text comments made within the survey using an inductive approach.

Results: We identified five overarching themes that influenced screening intention: 'personal health beliefs', 'practicalities', 'opinions of the test', 'attitudes towards screening' and 'cancer apprehension'. Overall, participants considered the tests presented as simple to complete and the benefits of early detection to outweigh any drawbacks to screening. Dominant facilitators and barriers varied with patterns of intention to take up screening across the four tests. Most intended to take up screening by all four tests, and for these participants, screening was seen as a positive health behaviour. A significant minority were driven by practicalities and the risks of the tests offered. A smaller proportion intended to reject all forms of screening offered, often due to fear or worry about results and unnecessary medical intervention or a general negative view of screening.

Conclusions: Most individuals would accept kidney cancer screening by any of the four test options presented because of strong positive attitudes towards screening in general and the perceived simplicity of the tests. Providing information about the rationale for screening in general and the potential benefits of early detection will be important to optimise uptake among uncertain individuals.

Keywords: kidney tumours; preventive medicine; public health; qualitative research.

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Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author). GDS has received educational grants from Pfizer, AstraZeneca and Intuitive Surgical; consultancy fees from Pfizer, Merck, EUSA Pharma and CMR Surgical; Travel expenses from Pfizer and Speaker fees from Pfizer. All other authors declare that (1) they have no support from or relationships with companies that might have an interest in the submitted work in the previous 3 years; (2) their spouses, partners or children have no financial relationships that may be relevant to the submitted work and (3) they have no non-financial interests that may be relevant to the submitted work.

Figures

Figure 1
Figure 1
Individual codes (facilitators and barriers) mapped onto overarching themes.
See this image and copyright information in PMC

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