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Colorectal Cancer Screening Among Midwestern Community-Based Residents: Indicators Of Success

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Abstract

Screening reduces the rate of death and morbidity resulting from CRC. Although CRC screening rates are low relative to other cancer screening tests, rates appear to be increasing: In 2004, 57% of adults ≥ 50 years reported up-to-date CRC screening test use; 14 states and Washington DC showed rates in excess of 60%. Identification of indicators of success and challenges remaining are important for universal goal achievement. The purpose of this study was to identify system and individual-level indicators of up-to-date CRC screening in a geographic area that reports higher uptake rates. Random-digit-dialing methods were used to survey a population-based community sample (N =  1033) of Midwestern adults ages 50 to 79 for CRC screening uptake in spring 2005. Adjusted odds ratio estimates were obtained using multivariate logistic regression. In total, about 62.6% of the sample reported up-to-date CRC screening. Compliant attitudes toward physicians’ screening recommendations were important indicators for up-to-date CRC screening; other individual-level psychosocial factors included beliefs about testing responsibility and testing safety. Non-current CRC screening was linked with testing anxiety and lack of perceived need for healthy people to test. System-level indicators associated with up-to-date CRC screening included reliance on physicians as the primary source for health information, family/personal history of bowel disease, regular physician visits, and participation in other cancer screening tests, controlling for age. Although population-based studies generally emphasize health system-level factors, individual-level attitudes such as feelings of responsibility to screen and adherence to physicians’ screening recommendations are important contributors to up-to-date CRC screening patterns.

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Authors and Affiliations

  1. Center for Patient Care & Outcomes Research, Medical College of Wisconsin, Suite H2755 8701 Watertown Plank Road, PO Box 26509, Milwaukee, WI, 53226-0509, USA

    B. Alex Matthews PhD

  2. Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, PO Box 26509, Milwaukee, WI, 53226-0509, USA

    Ann B. Nattinger MD, MPH

  3. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 8701 Watertown Plank Road, PO Box 26509, Milwaukee, WI, 53226-0509, USA

    Thangam Venkatesan MD & Reza Shaker MD

Authors
  1. B. Alex Matthews PhD
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  2. Ann B. Nattinger MD, MPH
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  3. Thangam Venkatesan MD
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  4. Reza Shaker MD
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Appendix

Appendix

Table 4 Final Weighted Logistic Regression Population Estimates: Indicators for Up-to-Date Colorectal Cancer (CRC) Screening Versus Non-Current Screening Test Use
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Matthews, B.A., Nattinger, A.B., Venkatesan, T. et al. Colorectal Cancer Screening Among Midwestern Community-Based Residents: Indicators Of Success. J Community Health 32, 103–120 (2007). https://doi.org/10.1007/s10900-006-9038-0

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