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Background: Socioeconomic status (SES) exhibits a graded relationship with health. Dispositional optimism represents a potential mediator and has been strongly linked to health, but few studies have assessed its association with SES., Purpose: To assess the relationship between SES and trait optimism and pessimism in a representative community sample of older British adults., Method: Community samples of adults (55-64 years) from Scotland (N = 10,650) and England (N = 5,099) registered with Primary Care Practices were mailed self-report questionnaires. Optimism was measured by the Life Orientation Test (LOT), which generates a total score and positive (optimism) and negative (pessimism) subscale scores. SES was assessed with an individual-level index of socioeconomic deprivation based on education, housing tenure, and car ownership., Results: In both samples, there was a strong SES gradient in the total LOT score, with higher SES being associated with higher scores. However, when pessimism and optimism subscales were analyzed separately, the gradient was strong for pessimism, but minimal for optimism., Conclusion: The results suggest that lower SES is associated with viewing the future as containing more negative events, but there was little SES difference for positive events. It will be important to distinguish the roles of pessimism and optimism in other determinants of health.

Background: Factors involved in forming intentions to attend cancer screening may be different from those involved in translating intentions into action., Purpose: To test the hypotheses that social cognition variables predict intention better than action, and that life difficulty variables predict action better than intention, in colorectal screening., Methods: Participants from one center in the UK Flexible Sigmoidoscopy Trial (n = 2,969) were categorized according to their screening intention, measured at baseline, and their subsequent attendance at screening (recorded at the clinic). Differences in factors related to life difficulty (socioeconomic deprivation, health, stress, social support) and social cognition variables were examined, and discriminant analysis was used to identify sets of variables that best differentiated the groups., Results: Social cognition variables were strongly associated with intention but only weakly with action. In contrast, factors related to life difficulties (socioeconomic deprivation, poor health status) were better predictors of action than intention., Conclusion: Social cognition variables appeared to be important determinants of screening intentions. Other variables--that may be markers of barriers to implementing plans--were more strongly associated with action. To maximize colorectal screening participation, research is needed to identify a wider range of determinants of attendance.

We assessed awareness of human papillomavirus (HPV) in a population sample of British women (n=1620) using similar questions to those in a survey in 2002. Only 2.5% cited HPV as the cause of cervical cancer without prompting; up from 0.9% in 2002. Public education about HPV is urgently needed.

This paper compares psychosocial and cognitive models of socioeconomic variation in participation in screening for colorectal cancer. The psychosocial model suggests that factors such as higher stress and lower social support explain, in part, why people from lower socioeconomic status (SES) environments are less likely to participate in screening. The cognitive model suggests that beliefs about cancer risk and screening will play an important part in differential participation. In practice both sets of factors may contribute to explaining socioeconomic differentials. The data for these analyses are drawn from a randomised controlled trial of colorectal cancer screening (the UK Flexible Sigmoidoscopy Trial). The participants are from the Scottish centre, where recruitment was stratified to generate a socioeconomically diverse sample. The dependent variable was interest in attending screening. A questionnaire covering demographic status, psychosocial and cognitive factors as well as interest in screening was sent to 10,650 adults. The results showed the predicted SES gradient in interest. There were also SES differences in both psychosocial and cognitive variables. A series of logistic regression models were used to test potential mediators of the association between SES and interest in attending screening by successively including psychosocial factors, cognitive factors, and then both, in the equation. Only the inclusion of the cognitive variables significantly reduced the variation associated with SES, providing better support for the cognitive than the psychosocial model.

Objectives: To investigate socioeconomic variation in participation in flexible sigmoidoscopy (FS) screening for colorectal cancer., Design: A prospective study nested within a multicentre randomised controlled trial of the efficacy of FS screening for the prevention and early detection of colorectal cancer (the UK flexible sigmoidoscopy trial)., Setting: Glasgow, Scotland., Participants: 55-64 year old adults, registered with general practitioners participating in the FS trial., Main Outcome Measures: Screening participation measured at three levels: questionnaire return; interest in screening; attendance at screening., Results: Socioeconomic deprivation was a strong predictor of participation. Return of the screening questionnaire, expression of interest in screening, and attendance at the test, were all lower in more deprived groups., Conclusions: These results highlight the need to consider ways to reduce inequalities in screening uptake, in parallel with the introduction of any new screening programmes, to avoid exacerbating social gradients in cancer mortality.