Behavioral research contributions and needs in cancer prevention and control: Adherence to cancer screening advice

Background. Research has been critical in understanding human behavior related to the early detection of cancer. Methods. Based on the literature and the author's experience, this paper reviews behavioral research accomplishments in the past decade and needs for the future. Results. Accomplishments have included an improved understanding of the barriers to screening, methods to improve the provision of tests by practitioners, and progress in the development and application of community interventions. Outstanding needs are summarized in 12 areas that include a continued focus on underserved populations and an examination of the use of screening tests in the presence of incomplete evidence of efficacy, translational research that explores the behavioral consequences of genetic susceptibility testing, continued development and use of computer-based technologies in the delivery of preventive services, and studies of the potential negative consequences of screening. Critical changes in the delivery of health care in the era of managed care call for increased behavioral research in health services and health care policy. Conclusion. Although this review of research needs is not exhaustive, it is clear that the challenges and opportunities for behavioral research are substantial, and this effort will be a critical part of the overall national research agenda for cancer control. (C) 1997 Academic Press.