Predictors of colorectal cancer screening: A comparison of men and women

Abstract

Background: New Canadian guidelines recommend screening average-risk adults to reduce mortality from colorectal cancer, the second most common cause of cancer death among Canadians. The present study examined the self-reported prevalence of colorectal cancer testing and sex-specific predictors of having had a fecal occult blood (FOB) test for screening, among a cohort of Alberta residents aged 50 to 69 years. Methods: Subjects (n=5009) enrolled in a geographically based cohort study completed a Health and Lifestyle Questionnaire between October 2000 and June 2002 that ascertained their colorectal cancer detection practices, as well as demographic and other health and lifestyle characteristics. Results: Patterns of FOB testing, and sigmoidoscopy or colonoscopy, were similar for men and women. The majority of subjects (83.3%) reported no first-degree family history of colorectal cancer or bowel conditions, and they were considered to be at average risk. Few average-risk subjects reported having a screening FOB test within the past two years (7.7% [95% CI 6.7% to 8.7%] of subjects aged 50 to 59 years and 12.5% [95% CI 10.9% to 14.3%] of subjects aged 60 to 69 years). In men, the strongest predictors of having a screening FOB test in the past two years were a recent history of prostate-specific antigen testing and educational attainment. Among women, the strongest predictors were a recent history of having had a Pap test, a recent mammogram, employment status and educational attainment. Conclusions: Screening for colorectal cancer in average-risk adults was infrequent in this sample and lagged behind screening for other cancers. Screening of average-risk adults occurred primarily in people already accessing the health care system, suggesting that public education programs will be required to increase screening rates. © 2005 Pulsus Group Inc. All rights reserved.