Lifestyle and occupational factors associated with participation in colorectal cancer screening among men and women in Australia

Renee N Carey,Sonia El-Zaemey

doi:10.1016/j.ypmed.2019.105777

Renee N Carey, Sonia El-Zaemey

Open Access

https://doi.org/10.1016/j.ypmed.2019.105777

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Journal: Preventive Medicine	Publication Date: Jul 15, 2019
Citations: 4	License type: cc-by

Affiliation: Curtin University

Abstract

This study explores the associations between lifestyle and occupational factors and participation in colorectal cancer (CRC) screening among men and women aged 50 and over and living in Australia. We used weighted data from the Australian National Health Survey 2014–15 to produce population estimates. Lifestyle variables investigated were smoking, physical activity, alcohol consumption, fruit and vegetable consumption, and body mass index, while the occupational variables were labour force status, occupation, and participation in shift work. Using weighted data, 1,990,287 men (55%) and 1,898,232 women (49%) reported ever-screening for CRC. Female current smokers were less likely to report ever-screening for CRC (adjusted RR = 0.78, 95% CI 0.64–0.96), as were men who were less physically active (aRR = 0.87, 95% CI 0.78–0.97), reported no alcohol consumption (aRR = 0.73, 95% CI 0.59–0.91), and reported eating more vegetables (aRR = 0.84, 95% CI 0.72–0.99). When lifestyle behaviours were combined into a healthy lifestyle index score, a significant trend was observed for both men and women, whereby those who reported engaging in more healthy behaviours were more likely to have ever-screened for CRC (p = .027 men; p < .001 women). No associations were observed between CRC screening and occupational variables. This is the first comprehensive assessment of the lifestyle and occupational factors associated with participation in CRC screening among men and women in Australia. Participation in CRC screening was greater among those engaging in more healthy behaviours, suggesting that an individual's pattern of lifestyle behaviours may be important in determining screening participation. These results have important implications for public health strategies on improving CRC screening participation.

Highlights

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Australia, with an estimated 47 new cases being diagnosed each day (Australian Institute of Health and Welfare, 2018a)
We found that 34% of men and 26% of women aged 50 and over reported screening for colorectal cancer (CRC) in the past two years, slightly lower than the participation rate reported by the National Bowel Cancer Screening Program (NBCSP) for the same period (35% of men and 40% of women; Australian Institute of Health and Welfare, 2016)
A previous Australian study found that lower levels of physical activity and non-drinking were associated with lower CRC screening participation rates, that study did not differentiate by gender (He et al, 2018)

Summary

Introduction

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Australia, with an estimated 47 new cases being diagnosed each day (Australian Institute of Health and Welfare, 2018a). It accounts for approximately 12.3% of all cancers diagnosed in Australia each year. Two-thirds (69.4%) of those diagnosed in 2010-2014 were still alive at five years post-diagnosis (Australian Institute of Health and Welfare, 2018a), with survival being highly dependent on stage at diagnosis (Levin et al, 2008). In Australia, the National Bowel Cancer Screening Program (NBCSP) provides government-funded, population-based CRC screening for Australian residents aged between 50 and 74 using an iFOBT (Australian Institute of Health and Welfare, 2018b). All eligible Australians are sent an iFOBT screening kit every two years, with results returned to the participant, their nominated health care provider, and the NBCSP register

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