Predictors of colorectal cancer screening participation in the United States

Ioannou, George N.; Chapko, Michael K.; Dominitz, Jason A.
September 2003
American Journal of Gastroenterology;Sep2003, Vol. 98 Issue 9, p2082
Academic Journal
: ObjectiveOur aim was to identify predictors of colorectal cancer screening in the United States and subgroups with particularly low rates of screening.: MethodsThe responses to a telephone-administered questionnaire of a nationally representative sample of 61,068 persons aged ≥50 yr were analyzed. Current screening was defined as either sigmoidoscopy/colonoscopy in the preceding 5 years or fecal occult blood testing (FOBT) in the preceding year, or both.: ResultsOverall, current colorectal cancer screening was reported by 43.4% (sigmoidoscopy/colonoscopy by 22.8%, FOBT by 9.9%, and both by 10.7%). The lowest rates of screening were reported by the following subgroups: those aged 50–54 yr (31.2%), Hispanics (31.2%), Asian/Pacific Islanders (34.8%), those with education less than the ninth grade (34.4%), no health care coverage (20.4%), or coverage by Medicaid (29.2%), those who had no routine doctor’s visit in the last year (20.3%), and every-day smokers (32.1%). The most important modifiable predictors of current colorectal cancer screening were health care coverage (OR = 1.7, 95% CI = 1.5–1.9) and a routine doctor’s visit in the last year (OR = 3.5, 95% CI = 3.2–3.8). FOBT was more common in women than in men (OR = 1.8, 95% CI = 1.6–2.0); sigmoidoscopy/colonoscopy was more common in Hispanics (OR = 1.4, 95% CI = 1.1–1.7) and Asian/Pacific Islanders (OR = 2.4, 95% = CI 1.5–3.9) relative to whites, in persons without routine doctor’s visits in the preceding year (OR = 3.3, 95% CI = 2.8–4), and in persons with poor self-reported health (OR = 1.3, 95% CI = 1.2–1.5).: ConclusionsInterventions should be developed to improve screening for the subgroups who reported the lowest screening rates. Such interventions may incorporate individual screening strategy preferences.


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