Predictors of Undergoing Colonoscopy, Does Time Horizon Matter?

Abstract

When talking to patients about undergoing diagnostic colonoscopy, their doctors can present the risk of developing colorectal cancer (CRC) in different time horizons. Studies on time horizons suggest that people have different psychological associations for the near and distant future, which potentially influence their judgments and actions. The aim of this study was to examine what factors predict patients' intentions to undergo diagnostic colonoscopy. We particularly focused on examining the role of the time horizon in which the probability of developing malignant CRC was presented, when taking into account the following factors: the perception of risk (perceived susceptibility to and perceived severity of CRC), expected discomfort related to the procedure, a previous colonoscopy, and subjective numeracy. Using the Health Belief Model, we sought to determine whether the intention to undergo a preventive colonoscopy is affected by the time horizon. We hypothesized that the risk of developing CRC in a proximal time horizon would be more threatening to an individual than a distal one and would consequently increase an individual's behavioral intention to undergo a colonoscopy. We examined the effects of two different time horizons: the risk of developing a disease in the next few years and total lifetime risk. A total of 144 respondents (77 women and 67 men) aged 50-59 years participated in the study. We found that risk perception and expected discomfort significantly affected participants' intention to undergo a colonoscopy. No empirical evidence was found to confirm that presenting a person with the risk of developing malignant CRC in the coming years, as compared to their lifetime risk, increases the behavioral intention to undergo a diagnostic colonoscopy.