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Cognitive ability and personality as predictors of participation in a national colorectal cancer screening programme: the English Longitudinal Study of Ageing
  1. Catharine R Gale1,2,
  2. Ian J Deary1,
  3. Jane Wardle3,
  4. Paola Zaninotto3,
  5. G David Batty1,3,4
  1. 1Department of Psychology, Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
  2. 2MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
  3. 3Department of Epidemiology and Public Health, University College London, London, UK
  4. 4Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Catharine R Gale, MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, SO16 6YD, UK; crg{at}


Background The English NHS Bowel Cancer Screening Programme has offered biennial faecal occult blood testing to people aged 60–69 years since 2006, and to those aged 60–74 years since 2010. Analysis of the first 2.6 million screening invitations found that 54% of eligible people took up the invitation. The reasons for this low uptake are unclear. We investigated whether participation in screening varies according to cognitive ability and personality.

Methods Participants were members of The English Longitudinal Study of Ageing. In 2010–2011, respondents were asked about participation in bowel cancer screening, and cognitive ability and the ‘Big Five’ personality traits were assessed. Logistic regression was used to examine the cross-sectional relationships between cognitive ability and personality and screening participation in 2681 people aged 60–75 years who were eligible to have been invited to take part in the UK national screening programme for bowel cancer.

Results In age-adjusted and sex-adjusted analyses, better cognition and higher conscientiousness were associated with increased participation in cancer screening. ORs (95% CIs) per SD increase were 1.10 (1.03 to 1.18) for cognitive ability and 1.10 (1.01 to 1.19) for conscientiousness. After further adjustment for household wealth and health literacy—shown previously to be associated with participation—these associations were attenuated (ORs were 1.07 (1.00 to 1.15) and 1.07 (0.97 to 1.18), respectively).

Conclusions We found some indication that better cognitive function and greater conscientiousness may be linked with a slightly increased likelihood of participation in bowel cancer screening. These relationships need investigation in other cohorts of older people.


This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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