Screeners vs. Non-screeners for Colorectal Cancer among People over 50 Years of Age: Factual and Psychological Discriminants

Abstract

Background and Aims: Colorectal cancer (CRC) is the third most frequent form of cancer worldwide, and approximately one third of cases have a positive family history of CRC or associated cancers. Colonoscopy is one of the most effective methods of screening for CRC. Uptake of colonoscopy is suboptimal, and many countries lack a national screening programme. Our study aims at exploring and ranking several factual and psychological variables according to their accuracy in discriminating between screeners and non-screeners for CRC in a convenience sample of people over 50 years of age.
 Methods: The study included 103 individuals aged over 50 years, recruited from day centres for the elderly. We explored socio-demographic variables, frequency of colonoscopy, previous recommendations for screening, health literacy and family history of cancer. Receiver operating characteristic (ROC) analysis was used to establish the discriminative value for each variable between the positive and negative decision for colonoscopy screening. Areas under the curve (AUC) and their equivalent Cohen‘s d values were calculated.
 Results: Almost a quarter (25.75%) of participants reported previous colonoscopy screening. ROC curve analysis shows that colonoscopy uptake is best discriminated by perceived benefits of screening (AUC=0.71, d=0.78, p<0.001), previous recommendations for screening (AUC=0.68, d=0.69, p<0.001) and previous recommendations for preventive measures (AUC=0.67, d=0.64, p<0.001).
 Conclusions: Recommendations from healthcare professionals lead to improved colonoscopy uptake when emphasising the benefits of screening. Results can further inform psychosocial interventions by bringing empirical evidence to emphasize screening benefits and explicit recommendations for individuals at risk for CRC cancer.

To Be Screened or Not to Be...? Psyche First?

“…Jaroslaw Regula 1,2 Po p u l at i o n a d h e re n c e t o c a n c e r s c r e e n i n g re c om m e n d at i on s i s n ot satisfactory in many countries. Public Health organizations have struggled to find ways to improve the situation.…”

“…Research is ongoing; however, no ideal methodology has been found, so far. In this issue of the Journal of Gastrointestinal and Liver Diseases two very interesting and valuable research studies on this topic are presented [1,2].…”

“…First, a study performed in Romania on a sample of people living in an urban area aged 50 years or more attending day care centers for elderly [1]. Of those, almost a quarter (26%) reported having previous colonoscopy screening despite the fact that Romania at the time of the study had no screening programme introduced yet.…”

Psychometric properties of a Chinese version of four-factor colorectal cancer screening belief scale

“…Cronbach’α coefficients were 0.822–0.964 for the subscales, and item-total correlations ranged from 0.422 to 0.912. 24 , 25 Although the CRCSBS overlaps with CCHBMS in three core concepts, the items used to measure the construct differ. Compared with CCHBMS, CRCSBS measures the psychological structures of CRC screening more specifically (33 items), while CCHBMS has only 17 items related to screening (other items are related to disease).…”