How has Acceptability Been Defined and Measured in Cancer Screening Research? A Scoping Review

Cancer screening is crucial for early detection and improved outcomes globally. Screening must be "acceptable" to health professionals and the public. However, acceptability definitions and measures have not always been made explicit. This scoping review aimed to explore the definitions, theories, and methods used by researchers investigating acceptability.

We conducted a term-based scoping review of published literature in six databases. Two independent reviewers screened citations for inclusion. Study characteristics (publication year, country, study design, sample size, population, methodological characteristics), characteristics of acceptability (definition, theory, test or device), and screening context (cancer type, screening procedure) were extracted by one author and checked independently by a second author. Results were reported descriptively. Definitions and operationalisations of acceptability were analysed through content analysis.

We identified 393 studies, largely published after 2013. Most examined patient or public attitudes towards self-sampling for cervical screening. Few studies cited theory (n = 55, 14%) or provided a definition of acceptability (n = 17, 4.3%). Acceptability was typically defined as a multidimensional construct or as perceptions or attitudes towards screening. Studies operationalised acceptability most often as physical side-effects (n = 68, 42.8%), willingness to attend screening (n = 59, 29.4%), screening method preference (n = 55, 27.4%), ease of use (n = 52, 25.9%), and general attitudes (n = 51, 25.4%).

Research focussed on acceptability in cancer screening has not been based on theory and uses a range of operationalisations, including loosely related constructs such as uptake. A specific definition of acceptability in cancer screening and reporting guidelines for interdisciplinary research are needed to support evidence-based decision-making.