An investigation of the factors that predict participation in colorectal cancer screening.

Ehlinger, S.F. (2001). An investigation of the factors that predict participation in colorectal cancer screening (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI No. 3021670)

Colorectal cancer is the second leading cancer killer in the United States. Compliance with screening guidelines is low among older, economically disadvantaged individuals, putting them at increased risk for colorectal cancer. The purpose of this study was to identify the critical psychosocial factors that predict compliance with colorectal cancer screening guidelines. 

Using a structured interview approach that elicited both quantitative and qualitative information, two hundred older, economically disadvantaged individuals were interviewed regarding their health history, awareness o f and participation in colorectal cancer screenings, social influences, exposure to colorectal cancer screening cues, and colorectal cancer beliefs. 

Receiving a health professional’s recommendation to get screened, being exposed to cues for colorectal cancer screening, believing regular colorectal cancer screenings are beneficial in that they will detect, prevent, and cure colorectal cancer, and having a history of diseases associated with colorectal cancer were associated with screening compliance among all the respondents. Specifically, receiving a recommendation from a health professional to get screened was associated with compliance among men, Caucasians, and individuals at moderate/high risk for colorectal cancer. Being exposed to cues for colorectal cancer screening was associated with screening compliance among females, Caucasians, and individuals at average risk for colorectal cancer. Believing that regular colorectal cancer screenings are beneficial was associated with screening compliance among men, women, Caucasians, minorities, and individuals at average risk for colorectal cancer. Having a history of diseases associated with colorectal cancer was related to screening compliance among men and minorities. Predictors of individual colorectal cancer screening tests were also identified in this study. While the majority of the participants were aware of each colorectal cancer screening, far fewer individuals reported having those tests, particularly in the case of flexible sigmoidoscopy, colonoscopy, and double contrast barium enema. 

The importance of a health professional’s recommendation in prompting screening compliance was consistently demonstrated in this study, indicating health professionals should be targeted in future interventions. Health professionals need to make strong, clear, and consistent recommendations regarding colorectal cancer screening to their patients. Findings from this study should be applied to the manner in which older, economically disadvantaged individuals are educated about colorectal cancer. 

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