Psychosocial Factors and Bowel Cancer Screening Among Middle-Aged and Older Australians: Evidence From a Population-Based Longitudinal Study

PurposeBowel cancer screening (BCS) is a critical preventive health measure. However, participation in BCS remains suboptimal in some populations. We aimed to examine the association between psychosocial factors and participation in bowel cancer screening among adults aged 45 years and above in Australia.DesignProspective cohort study.Setting and sampleOur study utilised longitudinal data from four waves of the Household, Income, and Labour Dynamics in Australia (HILDA) Survey, comprising 29 334 person-year observations from 11 315 individuals.MeasuresWe employed social connection, social isolation, and community membership as proxies for psychosocial factors and explored their relationship with bowel cancer screening participation.AnalysisWe performed descriptive statistics and random-effects logistic regression. The relationships were also stratified by age groups and gender to highlight heterogeneous effects.ResultsAfter adjusting for various confounding factors, our findings demonstrated that high social connection (adjusted Odds Ratio [aOR]): 1.14, 95% CI: 1.06-1.22) and community membership (aOR: 1.23, 95% CI: 1.15-1.32) were significantly and positively associated with participation in bowel cancer screening. Further stratified analysis revealed that this association was heterogeneous; the link between high social connection was significant for men (aOR: 1.17, 95% CI: 1.06-1.30) but not for women. Additionally, while community membership served as a significant predictor across all age groups, the positive association with social connection was evident in adults aged 45 to 59 (aOR: 1.13, 95% CI: 1.01-1.27) and those aged 60 to 74 years (aOR: 1.13, 95% CI: 1.09-1.36).ConclusionOur study highlighted the role of psychosocial factors in influencing participation in bowel cancer screening. Our results suggest that public health policies should prioritise initiatives that promote social engagement and strengthen community ties.