AccScience Publishing / HPR / Online First / DOI: 10.36922/hpr.0435
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RESEARCH ARTICLE

Clinical Psychological Correlates of Colorectal Cancer Screening Intention: Implications for Personalized Health Promotion Intervention

Maria Luisa Martino1†* ,  Daniela Lemmo1† ,  Rosa Fabbricatore2 ,  Marcella Bianchi3 ,  Anna Rosa Donizzetti1 ,  Maria Francesca Freda1 ,  Daniela Caso1
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1 Department of Humanities, University of Naples Federico II, Naples 80133, Campania, Italy
2 Department of Economics and Statistics, University of Naples Federico II, Naples 80126, Campania, Italy
3 Charité Center for Prevention, Health and Human Sciences, Charité – Universitätsmedizin Berlin, Berlin 10117, Germany
†These authors contributed equally to this work.
HPR, 0435 https://doi.org/10.36922/hpr.0435
Received: 14 December 2025 | Revised: 2 February 2026 | Accepted: 13 February 2026 | Published online: 5 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background

This study investigates clinical psychological factors associated with colorectal cancer (CRC) screening participation, with a specific focus on intention–behavior configurations within the intention–behavior gap framework.

Objective

From a mind–body perspective, we examine how emotion regulation, health anxiety, body awareness, and narcissistic traits are associated with screening decisions and may inform future personalized strategies to support participation.

Methods

A cross-sectional study was conducted with 224 adults (aged 50–81) completing an online survey assessing screening intention, behavior, and key psychological variables. Action-control profiles were created based on intention–behavior patterns, and differences were analyzed using Fisher’s exact tests and Kruskal–Wallis tests.

Results

Most participants (58%) were classified as non-intenders (low intention, no screening). Successful intenders (high intention, yes behavior) showed higher cognitive reappraisal than all other profiles, with small-to-moderate effect sizes (r = 0.25–0.53). Unsuccessful intenders (high intention, no behavior) exhibited higher disease phobia (r = 0.28), suggesting anxiety-related barriers to behavioral translation. Non-intenders who nonetheless engaged in screening (low intention, yes behavior) showed higher hypochondriacal beliefs and narcissistic vulnerability (r = 0.51), possibly reflecting screening behavior driven by concerns about illness or bodily cues.

Conclusion

Despite the cross-sectional design and convenience sampling that limit generalizability and prevent causal or temporal inferences, clinical psychological dimensions appear to be associated with CRC screening intention and participation. Our study attests to the importance of an integrative clinical approach that considers psychosomatic aspects, emotion regulation, health anxiety, and personality vulnerabilities to better understand ambivalence in screening behaviors. Preventive programs should address specific psychological barriers (e.g., health literacy) and foster self-care engagement. Future research should explore whether psychological factors, such as emotion regulation, health anxiety, and personality vulnerabilities, can guide the development of approaches aimed at reducing discrepancies between intention and self-reported screening behavior.

Keywords
Colorectal cancer screening
Intention-behavior
Emotion regulation
Health anxiety
Personality traits
Funding
This work was supported by the Federico II University of Naples, San Paolo Company Foundation, FRA PROJECT, MEMO-PRO.
Conflict of interest
The authors declare no competing interests.
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