Factors associated with colon cancer screening: the role of patient factors and physician counseling
Section snippets
Background
Colon cancer is the third leading cause of cancer and the second leading cause of cancer deaths in the US. In 2001, there were over 135,000 new cases and over 56,000 deaths from this disease [1]. Fortunately, recent studies suggest that early detection through different screening modalities, such as fecal occult blood testing (FOBT) and procedures including flexible sigmoidoscopy and colonoscopy, is effective in reducing mortality [2], [3]. Furthermore, screening appears to be cost effective [2]
The 2000 National Health Interview Survey
The NHIS is a continuing, in-person household survey about the health and healthcare use of the civilian, noninstitutionalized US population conducted by the National Center for Health Statistics [14]. In 2000, 100,618 persons (including children) from 43,437 households were surveyed, reflecting a response rate of 89%. One randomly selected adult from each household (n = 32,374) was also administered a supplemental Cancer Control Module, which included questions about cancer screening.
Screening for colon cancer
Of 11,427 respondents age 50–75 years in our sample, only 16% reported having completed annual FOBT and 29% reported having undergone either a flexible sigmoidoscopy in the preceding 5 years or a colonoscopy in the preceding 10 years; 36% were screened by FOBT, sigmoidoscopy, or colonoscopy. The mean age of respondents was 64 years. Those screened and unscreened were similar in age. Table 1 describes the unadjusted relationship between various factors and colon cancer screening. Non-Whites were
Comment
Our study confirms that screening for colorectal cancer continues to be low in the US. We observed an even lower prevalence of screening among Hispanics and those with lower education compared to their respective counterparts after adjustment, even though we found that members of these groups were no less adherent to physician recommendations to undergo screening in our study. Over 90% of patients who did not undergo screening were not counseled to do so by their physicians in the preceding
Acknowledgments
We thank the National Center for Health Statistics for providing the initial data. The analyses, interpretations, and conclusions in the manuscript, however, are those of the authors and do not reflect those of the National Center for Health Statistics.
The study was funded by a grant (R03 HS11683) from the Agency for Healthcare Research and Quality. Dr. Wee is also the recipient of a career development award from the National Institute of Diabetes, Digestive, and Kidney Diseases (K23 DK02962).
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