Factors for effective colorectal cancer screening

Screening for colorectal cancer: confuting the refuters

Measures for Ascertaining Use of Colorectal Cancer Screening in Behavioral, Health Services, and Epidemiologic Research

Colon Cancer Screening in 2005: Status and Challenges

Is there endoscopic capacity to provide colorectal cancer screening to the unscreened population in the United States?

This study's primary objective was to describe colorectal cancer (CRC) screening disparities using a guideline-derived definition of CRC screening adherence while controlling for confounding factors associated with CRC screening. This secondary data analysis of the 2000 National Health Interview Survey (NHIS) included 12,677 individuals age > or = 50 years. The primary outcome assessed was adherence to CRC screening guidelines, defined as a sigmoidoscopy or proctoscopy within the last five years, colonoscopy within the last 10 years, or home fecal occult blood test within the last 12 months. Age, race/ethnicity, gender, physical disability, household income, insurance status, education level, marriage status, rural or urban geographic area, and family history of CRC were analyzed as covariates in a logistic regression model. We assessed the association between these sociodemographic variables and receipt of physician recommendation for CRC screening among those respondents not adherent to CRC screening recommendations. In the multivariate model, the odds for being adherent with current CRC screening recommendations were lower for Hispanics (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.59-0.86) and African Americans (OR 0.82, 95% CI 0.71-0.95) than for Whites. Residents of urban areas had higher odds (OR 1.19, 95% CI 1.06-1.34) of being up-to-date than rural residents. Among subjects who were not up-to-date with CRC screening, similar disparities were noted in receipt of physician recommendation for CRC screening. Certain groups are at increased risk of not receiving CRC screening or recommendations for screening from their physicians. Interventions to reduce these disparities should be an integral part of overall efforts to improve CRC prevention and control.

Prospects for the worldwide control of colorectal cancer through screening

Comparing Risks and Benefits of Colorectal Cancer Screening in Elderly Patients

Flexible Sigmoidoscopy for Colorectal Cancer Screening in Canada

Comparing Attendance and Detection Rate of Colonoscopy With Sigmoidoscopy and FIT for Colorectal Cancer Screening

Colon Cancer Screening Models: Lessons and Challenges

Screening and Surveillance Colonoscopy and COVID-19: Avoiding More Casualties

Compared with other racial groups, African Americans have the highest colorectal cancer (CRC) incidence and mortality rates coupled with lower screening rates. Our study examined the predictors of stage of adoption for fecal occult blood testing (FOBT) and colonoscopy among African American primary care patients who were nonadherent to published screening guidelines. Baseline data (N = 815) in a randomized clinical trial were analyzed. Participants were categorized into precontemplation, contemplation, and preparation stages for FOBT and colonoscopy. Predictor variables were demographics, clinical variables, CRC health beliefs and knowledge, and social support. Hierarchical modeling was to identify significant predictors of stage of adoption. Older, male, Veterans Affairs participants and those with higher perceived self-efficacy, family/friend encouragement, and a provider recommendation had higher odds of being at a more advanced stage of adoption for FOBT. Patients with a history of cancer and higher perceived barriers had higher odds of being at an earlier stage of adoption for FOBT. Predictors of more advanced stage of adoption for colonoscopy included higher perceived benefits, higher perceived self-efficacy, family/friend encouragement, and a provider recommendation for colonoscopy. Higher income (>30 000 vs <15 000) was predictive of earlier stage of adoption for colonoscopy. Enhancing self-efficacy, encouragement from family and friends, and provider recommendations are important components of interventions to promote CRC screening. Nurses can use knowledge of the characteristics associated with stage of adoption to educate and motivate their African American primary care patients to complete CRC screening tests.

Introduction: Colorectal cancer (CRC) screening rates for Chinese and Korean Americans are one of the lowest among all racial and ethnic groups. A lack of knowledge and misconceptions surrounding CRC may be contributing factors of this disparity. Hence in this study, we sought to assess the relationship between knowledge with CRC screening behaviors and confidence among Chinese and Korean Americans. Methods: We recruited Chinese (n=59) and Korean Americans (n=61), 50 years and older, from the Washington, D.C. metropolitan area. CRC screening knowledge, behaviors, and confidence were assessed individually for participants through surveys and discussed in 12 focus group discussions (n=120). Mixed methods were employed to analyze the quantitative survey data and qualitative focus group data. For surveys, associations were analyzed using multivariate-adjusted logistic regression taking into account age, education, income, family history of CRC, having a regular physician, health insurance, and acculturation. Results: Based on both quantitative and qualitative analyses, participants exhibited a general lack of knowledge about CRC and CRC screening. About 7 out of 10 participants believed that CRC is usually fatal, and 3 out of 10 participants believed that there is nothing they could do to prevent CRC. In addition, over 50% of participants did not know that CRC screening is recommended from age 50 and that there are different CRC screening tests. Participants alluded to the lack of culturally and linguistically tailored health information as being a probable cause of low levels of CRC knowledge in these populations. However, family and friends were found to play an important role in encouraging screening behaviors and providing CRC-related information. For instance, one focus group participant shared about an occasion where she insisted that a friend and her husband receive CRC screening. The participant stated, “Her husband still calls me a lifesaver” after several polyps were found and removed during his colonoscopy. Individuals having a family member or friend, who received CRC screening or had a history of CRC, tended to have greater CRC knowledge. Furthermore, quantitative data and focus group discussions revealed misconceptions regarding CRC as being a western disease, ensuing false beliefs of having less susceptibility. Moreover, increased knowledge was associated with having confidence in getting screening and receiving CRC screening. In particular, those who believed that CRC screening will decrease chances of dying from CRC were 10.2 times more likely to get a fecal occult blood test (95% confidence interval: 3.9-26.6) and 10.7 times more likely to have a colonoscopy (95% confidence interval: 2.8-40.9). Conclusions: The combined use of surveys and focus groups provided a more in-depth examination and greater insight into how CRC knowledge impacts screening and confidence. Future efforts to increase CRC screening among Chinese and Korean Americans should (1) utilize family and friends as a channel to increase CRC knowledge and screening and (2) target the identified misconceptions held by these groups. Citation Format: Mary Jung, Xiaoxiao Lu, Julia Cen Chen, Daisy Le, Jingjing Chen, Sunmin Lee. Tell a Friend and Save a Life: Investigating the impact of knowledge on colorectal cancer screening behaviors and confidence among Chinese and Korean Americans using a mixed methods approach. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C67.

Screening For Colorectal Cancer in the Age of Simulation Models: A Historical Lens

Is colorectal cancer screening by fecal occult blood feasible?