PCN19: COLORECTAL CANCER SCREENING TESTS: VARIATION IN PREFERENCES BASED ON GENDER AND RACE

Abstract

BACKGROUND: There exists a larger number of screening procedures for colorectal cancer than for any other type of cancer. Unfortunately, screening rates remain low. Data from the Centers for Disease Control and Prevention (CDC) for 1999 suggest that only 33.7% of US adults over 40 have ever received a sigmoidoscopy (SIG) or colonoscopy (COL), and only 31.1% have ever received a fecal occult blood test (FOBT). OBJECTIVE: To better understand the types of barriers associated with each screening method (stool-based, scope-based, x-ray/enema-based) in order to develop patient-based preference profiles that could be used to increase compliance with one of the recommended screening regimens. METHODS: A national random sample of US adults 50 years and older was conducted via random digit dial methods. A computer assisted telephone survey was administered to 502 subjects. Data including utilization of FOBT, SIG, COL and x-ray with barium enema (XBE), demographics, concerns, attitudes and beliefs were collected. RESULTS: There were significant gender differences in screening rates based on procedure. Overall, 26.2% of women were in compliance with SIG recommendations compared to 38.6% of men (p < .01). White respondents appeared to be the source of this difference. Black/Hispanic men and women had similar SIG screening rates. Conversely, there was a significant difference in stool-based screening compliance between Black/Hispanic men (40.0%) and women (15.6%) with no gender difference among Whites. The importance of some potential barriers differed significantly with exam type (p < .05), with respondents being less bothered by, and associating less discomfort with, the FOBT. CONCLUSIONS: Preferences and perceptions with respect to screening procedures varied by patient characteristics. The impact of screening barriers varied by procedure. Understanding these variations may help in education and information dissemination and may also assist in directing patients to more compatible screening regimens. This might increase screening rates for this largely preventable disease.