Colorectal cancer screening awareness and intentions among low income, sociodemographically diverse adults under age 50

Abstract

Colorectal cancer (CRC) screening rates in the US are suboptimal, particularly among lower income and racial/ethnically diverse groups. If specific populations have limited awareness of screening when they reach age 50, there may be delays in screening adoption. This study investigated sociodemographic and social contextual factors associated with awareness of CRC and intentions to be screened at age 50 among 692 low income, racial, and ethnic minority adults living in low income housing. The majority of respondents (62%) were between ages 30 and 49, and 94% had some form of health insurance (e.g., Medicaid). About 70% reported having heard about CRC screening; 66% reported intentions to be screened at age 50. In multivariable analyses, screening awareness was associated with age and education. Immigrants who had English as a second language had lower awareness. Females tended to have higher awareness if they had private insurance; there were no differences among males. Multivariable analyses found that screening intentions were higher among men, those with more role responsibilities, more role conflicts, and higher levels of social cohesion. It is important to identify opportunities for maximizing screening uptake among those who become age-eligible for screening if we are to make a significant impact on CRC disparities.

Validity of APCS score as a risk prediction score for advanced colorectal neoplasia in Chinese asymptomatic subjects

“…Nevertheless, CRC screening is a resource-intensive activity requiring equipment and necessary infrastructure, in addition to trained medical personnel, [ 22 ] which limits its wider use in deprived settings owing to the resource constraints. [ 23 , 24 ] Moreover, lack of awareness in the target population, inadequate advocacy by healthcare professionals, and poor compliance [ 25 – 30 ] are some of the other barriers that have hampered the implementation of CRC screening programs. Screening guidelines for western countries are not feasible to implement in China owing to the large population base and inadequate resource allocation for CRC screening.…”

Patient Numeracy, Perceptions of Provider Communication, and Colorectal Cancer Screening Utilization

“…Despite evidence that survival is highest at early stage of disease, CRC screening rates continue to be below recommended targets ((CDC), 2006). Risk factors for underutilization of CRC screening include a lack of health insurance, being a member of a racial/ethnic minority group, having less education and/or a low income (Cairns & Viswanath, 2006; Emmons et al, 2008; Meissner, Breen, Klabunde, & Vernon, 2006; Mobley et al, 2009). The identification of risk factors that could be targeted in health promotion interventions to improve the utilization of CRC screening remains a research and clinical priority.…”

Changes in colorectal cancer screening intention among people aged 18–49 in the United States

“…This paper is a secondary analysis of data from ODH, which has been discussed in detail elsewhere [ 21 – 23 ]. Briefly, ODH was a CRC prevention trial delivered within 12 low-income housing sites in metropolitan Boston, Massachusetts, United States.…”

“…CRC screening intention was assessed at the baseline and follow-up survey by the question: “Do you plan to be screened for colon cancer?” (yes, no, don’t know) [ 21 ]. These data were used to create the variable, change in CRC screening intention.…”

“…child or parental care giving and primary economic obligation), greater role conflicts (e.g. conflict between daily activities and life demands), and reported higher levels of social cohesion in their community had a greater intention to participate in CRC screening upon turning 50 [ 21 ]. Identifying factors associated with changes in CRC screening intentions among adults less than 50 may allow for salient programs and communication strategies to be developed, which may contribute to an increase in the number of adults who participate in CRC screening as soon as they turn 50 and potentially reduce preventable morbidity and mortality.…”