Abstract
Background
As the global cancer burden rises, organised screening provides the opportunity for mortality reduction. Thinking styles, rational thinking (measured by Need for Cognition (NFC)) and experiential thinking (measured by Faith in Intuition (FI)), are potential intervention targets. This systematic review synthesises evidence on differences in thinking style across sociodemographic factors in the context of cancer screening to inform future interventions.
Methods
Seven databases were searched. Eligibility criteria (using the Population, Exposure, Comparison, and Outcome (PECO) framework) included studies measuring NFC or FI in the context of cancer screening. Title, abstract, and full text were screened by two independent reviewers and findings summarised using narrative synthesis.
Results
Six studies (N = 3,380) were included, covering breast (mammography), bowel (Colonoscopy and faecal tests(FT)), and prostate (Digital rectal exam and prostate-specific antigen) cancer screening, 5 of which included only NFC measures and 1 both NFC and FI. Heterogeneity in NFC scales and item use was noted (Mean=3.34-10.4) and only one study reported on FI (Mean=3.63). Findings indicate that higher NFC is associated with being male, non-white, higher education, and lower socioeconomic disadvantage. Lower FI is associated with higher education. NFC was negatively associated with defensiveness (avoidance/blunting) and positively associated with information appraisal (perceived usefulness, attention, gain-framed effect, narrative style). However, the direct impact of NFC and FI on screening intention and participation remains inconsistent.
Conclusions
Evidence points to rational thinking being associated with better engagement with screening information, while both rational and experiential thinking require further research. Future studies should clarify how these styles influence key elements of the decision to participate in cancer screening.
Key messages
• Thinking style appears to be socio-economically patterned and associated with differences in screening intention and participation.
• Rational thinking appears to be is associated with better information appraisal, however few studies have investigated this and are heterogenous in measurement.