Colorectal cancer screening adherence in a general population.

BACKGROUND This article describes the self-reported colorectal cancer (CRC) screening adherence rates of adults, aged 50 years and older, living in five nonurban Minnesota counties. METHODS During the year 2000, 1693 eligible respondents, aged 50 years and older, from a randomly selected sample completed a survey assessing CRC screening adherence (approximately 86.3% response). The survey allowed differentiation between the four CRC screening modalities but did not differentiate between screening and diagnostic testing. Adjustment for nonresponse was performed using a version of Horvitz-Thompson weighting accounting for unknown eligibility. RESULTS 24.5% of respondents had a fecal occult blood test within 1 year of the survey, 33.8% had flexible sigmoidoscopy within 5 years, 29.3% had a colonoscopy within 10 years, and 13.7% had a barium enema within the last 5 years. Overall, 55.3% of respondents reported testing by any modality; thus, 44.7% were not adherent to screening guidelines. CONCLUSIONS This study improves on previous attempts to characterize CRC screening adherence by assessing all four modalities of screening as recommended by current screening guidelines, by focusing on nonadherence, and by rigorously accounting for nonresponse. This study confirms that nearly half of the population remains unscreened by any method.

[1]  A. Jemal,et al.  Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control. , 2003, Journal of the National Cancer Institute.

[2]  Nancy Breen,et al.  Progress in cancer screening practices in the United States , 2003, Cancer.

[3]  S. Woolf,et al.  Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. , 2003, Gastroenterology.

[4]  U. P. S. T. Force,et al.  Screening for Colorectal Cancer: Recommendation and Rationale , 2002, Annals of Internal Medicine.

[5]  D K Wagener,et al.  Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. , 2001, Journal of the National Cancer Institute.

[6]  Nancy Breen,et al.  Progress in Cancer Screening over a Decade, Results of Cancer Screening from the 1987, 1992, and 1998 NHIS , 2001 .

[7]  L M Schuman,et al.  The effect of fecal occult-blood screening on the incidence of colorectal cancer. , 2000, The New England journal of medicine.

[8]  Sandra L. Edwards,et al.  Colon cancer screening, lifestyle, and risk of colon cancer , 2000, Cancer Causes & Control.

[9]  D. Ahnen,et al.  Validity of self-reported colorectal cancer screening behavior. , 2000, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[10]  A. LaCroix,et al.  Comparison of self-reported fecal occult blood testing with automated laboratory records among older women in a health maintenance organization. , 1999, American journal of epidemiology.

[11]  C. Mulrow,et al.  Colorectal cancer screening: clinical guidelines and rationale. , 1997, Gastroenterology.

[12]  J. Olsen,et al.  Randomised study of screening for colorectal cancer with faecal-occult-blood test , 1996, The Lancet.

[13]  A. Sonnenberg,et al.  Prevention of Colorectal Cancer by Flexible Endoscopy and Polypectomy: A Case-Control Study of 32 702 Veterans , 1995, Annals of Internal Medicine.

[14]  A. Sonnenberg,et al.  Protection by endoscopy against death from colorectal cancer. A case-control study among veterans. , 1995, Archives of internal medicine.

[15]  W. Phillips,et al.  Cancer screening by primary care physicians: a comparison of rates obtained from physician self-report, patient survey, and chart audit. , 1995, American journal of public health.

[16]  L M Schuman,et al.  Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. , 1993, The New England journal of medicine.

[17]  R. Hiatt,et al.  Concordance of self-reported data and medical record audit for six cancer screening procedures. , 1993, Journal of the National Cancer Institute.

[18]  B E Storer,et al.  Screening sigmoidoscopy and colorectal cancer mortality. , 1992, Journal of the National Cancer Institute.

[19]  G. Friedman,et al.  A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. , 1992, The New England journal of medicine.

[20]  S. Moss,et al.  Randomised controlled trial of faecal-occult-blood screening for colorectal cancer , 1989, The Lancet.

[21]  D. Horvitz,et al.  A Generalization of Sampling Without Replacement from a Finite Universe , 1952 .

[22]  Alicia Samuels,et al.  Cancer Statistics, 2003 , 2003, CA: a cancer journal for clinicians.

[23]  Robert A. Smith,et al.  American Cancer Society Guidelines for the Early Detection of Cancer, 2003 , 2003, CA: a cancer journal for clinicians.

[24]  S. Erban,et al.  Colorectal cancer screening in Massachusetts: measuring compliance with current guidelines. , 2001, Effective clinical practice : ECP.

[25]  Trends in screening for colorectal cancer--United States, 1997 and 1999. , 2001, MMWR. Morbidity and mortality weekly report.

[26]  S Kamen,et al.  The task force. , 1976, Journal of hospital dental practice.