Does colorectal cancer risk perception predict screening behavior? A systematic review and meta-analysis

Area of Science:

• Public Health
• Behavioral Science
• Oncology

Background:

• Health behavior theories suggest perceived risk motivates health actions.
• The relationship between colorectal cancer (CRC) risk perception and screening behavior requires clarification.
• Understanding this link is vital for improving CRC screening uptake.

Purpose of the Study:

• To meta-analyze the association between CRC risk perception and screening behavior.
• To investigate potential moderators influencing this relationship.
• To assess the impact of study quality on the observed association.

Main Methods:

• Systematic literature search across six databases.
• Inclusion of 58 studies with 63 effect sizes quantitatively assessing the CRC risk perception-screening behavior link.
• Random-effects meta-analysis to determine the overall effect size and heterogeneity.

Main Results:

• A majority of studies (75%) reported a positive association between CRC risk perception and screening behavior.
• The overall meta-analysis revealed a small, positive relationship (z = 0.13).
• Significant heterogeneity was observed (I² = 99%), with higher quality studies showing a weaker association (z = 0.02) compared to lower quality studies (z = 0.16).

Conclusions:

• A small, positive relationship exists between colorectal cancer risk perception and screening behavior.
• Study quality is a critical factor influencing the observed association.
• Future research should prioritize high-quality study designs to better understand this relationship.