Perspectives on cancer screening participation in a highly urbanized region: a Q-methodology study in The Hague, the Netherlands

Thomas H G Bongaerts; Frederike L Büchner; Matty R Crone; Job van Exel; Onno R Guicherit; Mattijs E Numans; Vera Nierkens

doi:10.1186/s12889-022-14312-4

Perspectives on cancer screening participation in a highly urbanized region: a Q-methodology study in The Hague, the Netherlands

BMC Public Health. 2022 Oct 15;22(1):1925. doi: 10.1186/s12889-022-14312-4.

Authors

Thomas H G Bongaerts^{1

2}, Frederike L Büchner^{3

4}, Matty R Crone⁴, Job van Exel^{5

6}, Onno R Guicherit⁷, Mattijs E Numans^{3

4}, Vera Nierkens⁴

Affiliations

¹ Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands. t.h.g.bongaerts@lumc.nl.
² Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. t.h.g.bongaerts@lumc.nl.
³ Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands.
⁴ Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
⁵ Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
⁶ Erasmus Centre for Health Economics Research, Erasmus University Rotterdam, Rotterdam, The Netherlands.
⁷ University Cancer Center Leiden - The Hague, at Haaglanden Medical Center, The Hague, The Netherlands.

Abstract

Background: The Netherlands hosts, as many other European countries, three population-based cancer screening programmes (CSPs). The overall uptake among these CSPs is high, but has decreased over recent years. Especially in highly urbanized regions the uptake rates tend to fall below the minimal effective rate of 70% set by the World Health Organization. Understanding the reasons underlying the decision of citizens to partake in a CPS are essential in order to optimize the current screening participation rates. The aim of this study was to explore the various perspectives concerning cancer screening among inhabitants of The Hague, a highly urbanized region of the Netherlands.

Methods: A Q-methodology study was conducted to provide insight in the prevailing perspectives on partaking in CSPs. All respondents were inhabitants of the city of The Hague, the Netherlands. In an online application they ranked a set of 31 statements, based on the current available literature and clustered by the Integrated Change model, into a 9-column forced ranking grid according to level of agreement, followed by a short survey. Respondents were asked to participate in a subsequent interview to explain their ranking. By-person factor analysis was used to identify distinct perspectives, which were interpreted using data from the rankings and interviews.

Results: Three distinct perspectives were identified: 1). "Positive about participation", 2). "Thoughtful about participation", and 3). "Fear drives participation". These perspectives provide insight into how potential respondents, living in an urbanized region in the Netherlands, decide upon partaking in CSPs.

Conclusions: Since CSPs will only be effective when participation rates are sufficiently high, it is essential to have insight into the different perspectives among potential respondents concerning partaking in a CSP. This study adds new insights concerning these perspectives and suggests several ideas for future optimization of the CSPs.

Keywords: Cancer screening; I-Change model; Participation; Perspectives; Q-methodology; Uptake.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Early Detection of Cancer*
Humans
Mass Screening
Neoplasms* / diagnosis
Neoplasms* / prevention & control
Netherlands
Surveys and Questionnaires