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Why people fail to participate in annual skin cancer screening: creation of the perceptions of annual skin cancer screening scale (PASCSS)

  • Matt C. Howard EMAIL logo
Published/Copyright: December 22, 2022
Diagnosis
From the journal Diagnosis Volume 10 Issue 2

Abstract

Objectives

Many studies show that most people, even at-risk individuals, do not undergo routine clinical skin cancer screening, and many questions remain unanswered regarding the participation (or lack thereof) in annual skin cancer screening. Perhaps the largest unanswered question is the most essential: why do people fail to undergo annual skin cancer screening? We provide an avenue to answer this question by creating the Perceptions of Annual Skin Cancer Screening Scale (PASCSS).

Methods

In Study 1, we conduct a qualitative investigation to identify potential scale dimensions and items (n=233). In Study 2, we test the validity and psychometric properties of our initial item list via exploratory factor analysis (n=406). In Study 3, we further test the psychometric properties of our item list via confirmatory factor analysis (n=587).

Results

These three studies provide strong support for the validity and psychometric properties of our item list, resulting in the PASCSS. The PASCSS includes 48 items and 12 dimensions that each represent unique perceptions regarding annual skin cancer screening.

Conclusions

We encourage future authors to utilize the PASCSS to identify those most at risk for failing to participate in annual skin cancer screening as well as develop adaptive interventions that can target these participants.

Keywords: cancer; dermatology; patient perceptions; preventive behaviors; scale development; skin cancer; skin cancer screening
Corresponding author: Dr. Matt C. Howard, University of South Alabama, Mitchell College of Business, 5811 Drive S., Rm. 337, Mobile, AL, 36688, USA, E-mail:

  1. Research funding: None declared.

  2. Author contributions: The author has accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Author states no conflict of interest.

  4. Informed consent: No written consent was obtained to ensure maximum anonymity. Due to the very low risk of the study, an information sheet was instead provided to participants.

  5. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the primary author’s institution and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All procedures were approved by the IRB of the primary author’s institution (IRB#: 1663301).

Appendix A Perceptions of annual skin cancer screening scale

Please indicate your extent of disagreement to agreement for each of the following statements using the scale below.

1 = Strongly Disagree

2 = Disagree

3 = Slightly Disagree

4 = Neither Disagree or Agree

5 = Slightly Agree

6 = Agree

7 = Strongly Agree

Answer each item as if it began with,“If I do not get a yearly full-body skin cancer screening with either a primary care provider or dermatologist, it is because…”

Cost

  1. I do not have the money to do so.

  2. It is too expensive.

  3. My insurance (or lack thereof) may not cover it.

  4. The price is too high.

Time

  1. There are not any times that I could go.

  2. I am unable to miss or be late for work and/or other obligations.

  3. I cannot spare the time right now.

  4. My schedule is too busy.

Not needed

  1. It is pointless.

  2. You can just handle any skin problems yourself.

  3. It is only necessary to go when you have a skin problems.

  4. It is only necessary to go when something is wrong.

Not risk

  1. I do not have any skin problems, such as signs of skin cancer.

  2. I think that I am healthy.

  3. I do not have any conditions that warrant a visit.

  4. I take enough precautions.

Inconvenient

  1. It is too inconvenient.

  2. It is a hassle.

  3. I cannot be bothered to go.

  4. It is too irritating to go.

Forget

  1. I never think about it.

  2. I do not think about skin problems, such as skin cancer.

  3. It does not often come to my mind.

  4. I do not really consider it.

Undesirable

  1. I am scared of being diagnosed with cancer.

  2. I am scared that something will be wrong with me.

  3. I am afraid that they might find an issue.

  4. I am afraid of bad news.

Undesirable doctor interactions

  1. I do not trust doctors.

  2. I fear doctors.

  3. I do not like going to a doctor’s office or hospital.

  4. I prefer to just avoid doctors.

Access

  1. There are not any available doctors near me.

  2. I do not know where to find an available doctor.

  3. I am not sure who to go to.

  4. I do not have any available providers.

Unknowledgeable

  1. I did not know it was recommended to go for yearly appointments.

  2. I did not realize that yearly dermatologist visits are recommended.

  3. I did not know that this was something that I should be doing.

  4. I did not recognize the importance of a yearly checkup.

Recommended

  1. My primary care provider has never recommended it to me.

  2. My doctor has never brought it up.

  3. My doctor has never offered to perform one.

  4. My doctor has never suggested that I should get one.

Uncomfortable

  1. It would be embarrassing.

  2. The procedure would invade my privacy.

  3. I would feel ashamed.

  4. I do not want to feel judged.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/dx-2022-0077).

Received: 2022-07-25
Accepted: 2022-12-05
Published Online: 2022-12-22

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. An equation for excellence in clinical reasoning
  4. Quantifying diagnostic excellence
  5. Review
  6. A scoping review of distributed cognition in acute care clinical decision-making
  7. Opinion Papers
  8. Context matters: toward a multilevel perspective on context in clinical reasoning and error
  9. Occam’s razor and Hickam’s dictum: a dermatologic perspective
  10. Original Articles
  11. Differences in clinical reasoning between female and male medical students
  12. Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum
  13. Bad things can happen: are medical students aware of patient centered care and safety?
  14. Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms
  15. Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis
  16. Empowering quality data – the Gordian knot of bringing real innovation into healthcare system
  17. Collective intelligence improves probabilistic diagnostic assessments
  18. Why people fail to participate in annual skin cancer screening: creation of the perceptions of annual skin cancer screening scale (PASCSS)
  19. Instructions on appropriate fasting prior to phlebotomy; effects on patient awareness, preparation, and biochemical parameters
  20. Clinician factors associated with delayed diagnosis of appendicitis
  21. Real-world assessment of the clinical performance of COVID-VIRO ALL IN rapid SARS-CoV-2 antigen test
  22. Lack of a prompt normalization of immunological parameters is associated with long-term care and poor prognosis in COVID-19 affected patients receiving convalescent plasma: a single center experience
  23. Letters to the Editor
  24. Uncontrolled confounding in COVID-19 epidemiology
  25. VAPES: a new mnemonic for considering paroxysmal disorders
  26. Congress Abstracts
  27. SIDM2022 15th Annual International Conference
https://doi.org/10.1515/dx-2022-0077
Keywords for this article
cancer; dermatology; patient perceptions; preventive behaviors; scale development; skin cancer; skin cancer screening

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. An equation for excellence in clinical reasoning
  4. Quantifying diagnostic excellence
  5. Review
  6. A scoping review of distributed cognition in acute care clinical decision-making
  7. Opinion Papers
  8. Context matters: toward a multilevel perspective on context in clinical reasoning and error
  9. Occam’s razor and Hickam’s dictum: a dermatologic perspective
  10. Original Articles
  11. Differences in clinical reasoning between female and male medical students
  12. Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum
  13. Bad things can happen: are medical students aware of patient centered care and safety?
  14. Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms
  15. Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis
  16. Empowering quality data – the Gordian knot of bringing real innovation into healthcare system
  17. Collective intelligence improves probabilistic diagnostic assessments
  18. Why people fail to participate in annual skin cancer screening: creation of the perceptions of annual skin cancer screening scale (PASCSS)
  19. Instructions on appropriate fasting prior to phlebotomy; effects on patient awareness, preparation, and biochemical parameters
  20. Clinician factors associated with delayed diagnosis of appendicitis
  21. Real-world assessment of the clinical performance of COVID-VIRO ALL IN rapid SARS-CoV-2 antigen test
  22. Lack of a prompt normalization of immunological parameters is associated with long-term care and poor prognosis in COVID-19 affected patients receiving convalescent plasma: a single center experience
  23. Letters to the Editor
  24. Uncontrolled confounding in COVID-19 epidemiology
  25. VAPES: a new mnemonic for considering paroxysmal disorders
  26. Congress Abstracts
  27. SIDM2022 15th Annual International Conference
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