A survey of women regarding factors affecting colorectal cancer screening compliance

Background. Women participate in colorectal cancer (CRC) screening less often than men. Our study objective was to understand factors related to women's use of CRC screening. We examined the personal health, medical care, and psychosocial responses to CRC and screening use of a community-based sample of women. Methods. Women aged 50-80 years at average CRC risk completed a telephone questionnaire. We asked about demographics, past use of CRC and other cancer screening tests, preventive health measures, source of primary care, and comorbidities. We also inquired about attitudes and risk perceptions regarding CRC, knowledge about CRC screening, and other frequent health concerns. Logistic regression identified predictors of screening compliance. Results. Four hundred six women (52% of women contacted, average age 63 years) provided responses. Sixty-five percent had completed some form of CRC screening in the past 5 years. Four factors were positively related to CRC screening: increasing age [adjusted odds ratio (AOR) = 1.05, (95% CI 1.03, 1.08)], perceived CRC risk [AOR = 1.92, (95% Cl 1.19, 3.16)], belief that screening reduces CRC risk (AOR = 2.49, 95% Cl 1.45, 4.27), and belief in following screening guidelines [AOR = 4.95, (95% Cl 2.07, 11.90)]. Belief that screening would be painful [AOR = 0.52, (95% CI 0.32, 0.84)] was inversely related. Conclusions. Fear about CRC screening-related pain was the strongest impediment to screening, whereas positive attitudes about the value of CRC screening were strongly related to compliance. Addressing fears and emphasizing positive messages by providers should be included in programs promoting CRC screening in women. (C) 2004 The Institute for Cancer Prevention and Elsevier Inc. All rights reserved.