Defensiveness in Cancer Screening and Prevention: A Scoping Review of Definitions, Measures and Profiles

Organised population-based cancer screening invites identified populations to undergo a test, usually at regular intervals, to detect early-stage cancers or pre-cancerous lesions, with the aim of reducing cancer-specific mortality rates, and, in some cases, cancer-specific incidence. Emerging research highlights the role of cognitive factors, particularly defensive information processing (DIP), in influencing screening participation. This scoping review aims to; 1) shed light on how defensive information processing is defined and measured in cancer screening studies, 2) provide an overview of the use of theories and conceptual frameworks in such studies, 3) describe defensive information processing profiles and related outcomes in cancer screening studies, and 4) describe intervention strategies aimed at reducing defensive reactions to cancer screening. The scoping review will follow the Joanna Briggs Institute (JBI) guidelines and will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) for scoping reviews. The Population, Context, Concept (PCC) framework is used to define eligibility criteria. Relevant studies will be retrieved via 6 databases (Scopus, Web of Science, EMBASE, Medline, CINAHL, PsychINFO and CENTRAL). Quantitative studies of cancer screening will be included if they report original research that defines, measures, and/or intervenes on any aspect of Defensive information processing, consistent with the conceptualisations by McQueen et al. (attention avoidance, blunting, suppression, and counterarguing). Two reviewers will independently screen published abstracts, full-text articles, and extract data from the final included studies using a standardised extraction form. Extracted data will be reported using narrative synthesis. This scoping review will be the first to report on the range of literature on all or some domains of defensive information processing in cancer screening contexts, since the publication of McQueen et al’s conceptual model. By capturing the scope of research beyond McQueen et al.’s work, this review aims to provide an evidence base to inform future interventions addressing defensiveness in cancer screening.