Cancer risk perception and physician communication behaviors on cervical cancer and colorectal cancer screening.

Diane M Harper,Madiha Tariq,Nadia Syed,Ken Resnicow,Asraa Alhawli,Minal Patel

doi:10.7554/elife.70003

Abstract

Women 50-65 years of age have the lowest cervical and colorectal cancer (CRC) screening rates among ages recommended for screening. The primary aim of this work is to determine how cancer risk perceptions and provider communication behaviors, in addition to known demographic factors, influence the uptake of both cervical and CRC screening or a single screen among women in southeast Michigan. Fourteen health services and communication behavior questions were adapted from the Health Information National Trends Survey (HINTS) and administered to a multiethnic sample of adults in southeast Michigan. The outcome variable was self-reported up-to-date cervical cancer and/or CRC screening as defined by the United States Preventive Services Task Force (USPSTF). Demographic and cancer risk/communication behavior responses of the four screening populations (both tests, one test, no tests) were analyzed with multinomial regression for all comparisons. Of the 394 respondents, 54% were up to date for both cervical and CRC screening, 21% were up to date with only cervical cancer screening and 12% were up to date for only CRC screening. Of the 14 risk perception and communication behavior questions, only 'Did your primary care physician (PCP) involve you in the decisions about your health care as much as you wanted?' was significantly associated with women having both screens compared to only cervical cancer screening (aOR 1.67; 95% CI: 1.08, 2.57). The multivariate model showed age, and Middle East and North African (MENA) ethnicity and Black race, in addition to PCP-patient dyad decision-making to be associated with the cancer screenings women completed. Optimizing PCP-patient decision-making in health care may increase opportunities for both cervical cancer and CRC screening either in the office or by self-sampling. Understanding the effects of age and the different interventional strategies needed for MENA women compared to Black women will inform future intervention trials aimed to increase both cancer screenings. This work was supported by NIH through the Michigan Institute for Clinical and Health Research UL1TR002240 and by NCI through The University of Michigan Rogel Cancer Center P30CA046592-29-S4 grants.

Highlights

Women 50–65 years of age have the lowest cervical cancer screening rate among those 21–65 years of age, as reported in three national surveillance databases: Behavioral Risk Factor Surveillance System (BRFSS), Health Information National Trends Survey (HINTS), and Health Center Patient Survey (HCPS) (Harper et al, 2020)
As we have previously reported in the evaluation of women in southeast Michigan, those more likely to be up to date for only cervical cancer screening compared to both colorectal cancer (CRC) and cervical cancer screens are younger women and women of Middle East and North African (MENA) ethnicity (Harper et al, 2021a)
The primary aim of our study was to determine if CRC and/or cervical cancer screening uptake among the multiethnic sample of White, Black, and MENA women 50–65 years of age from southeast Michigan was associated with personal risk perceptions, cancer risk perceptions, and physician communication behavior

Summary

Introduction

Women 50–65 years of age have the lowest cervical cancer screening rate among those 21–65 years of age, as reported in three national surveillance databases: Behavioral Risk Factor Surveillance System (BRFSS), Health Information National Trends Survey (HINTS), and Health Center Patient Survey (HCPS) (Harper et al, 2020). As we have previously reported in the evaluation of women in southeast Michigan, those more likely to be up to date for only cervical cancer screening compared to both CRC and cervical cancer screens are younger women and women of Middle East and North African (MENA) ethnicity (Harper et al, 2021a). The primary aim of this work is to determine how cancer risk perceptions and provider communication behaviors, in addition to known demographic factors, influence the uptake of both cervical and CRC screening or a single screen among women in southeast Michigan.

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Conclusion