Prevalence and Factors Associated with Colorectal Cancer Screening in Canadian Women

Abstract

This representative study investigated the prevalence and factors associated with women's use of colorectal cancer (CRC) screening. Women aged 50-74 were selected from the Ontario subsample of the 2005 Canadian Community Health Survey. Women who had never screened for CRC (n = 3676) were compared with women who had ever had CRC screening (n = 2105). Andersen's Behavioral Model of Health Service Use of predisposing, need, and enabling factors guided chi-square and logistic regression analyses. Fully 38% of women reported ever having CRC screening. Predisposing factors (older age, higher education, white race, currently having cancer [not CRC], and use of other screening tests), need factors (nonsmoking and physical activity level), and enabling factors (urban location, having a family doctor, more than five doctor visits annually, and greater sense of belonging), were each associated with higher odds of screening. Lower household income seemed to be associated with lower odds of screening. Despite CRC guidelines published before and during 2004, only 38% of women reported ever having CRC screening by 2005. Enabling factors contributed significantly to screening rates after adjustment for need factors, which provides some evidence that access to CRC screening by women was inequitable despite Canada's publicly funded healthcare system. Research findings can help develop female-specific strategies to increase rates of CRC screening.