Abstract
Colorectal cancer (CRC) screening is underused in the United States, and non-adherence with screening recommendations is high
in some populations. This study describes the characteristics of people who have never been screened for CRC. In addition,
we use the health belief model to examine the constructs associated with screening behavior. We used data from the 2010 Behavioral
Risk Factor Surveillance System (BRFSS) to create three study outcomes: people who have been screened for CRC and are up-to-date
with current recommendations, people who have been screened but are not up-to-date, and people who have never been screened.
We used multivariate logistic regression modeling to calculate predicted marginal estimates examining the associations between
the screening outcomes and demographic and Health Belief Model (HBM) characteristics. Overall 29 % of respondents had never
been screened for CRC. In the adjusted model, 36.6 % of US adults age 50–59 years and 29.1 % of US men reported never being
screened for CRC. More Asian/Native Hawaiian/Pacific Islander, non-Hispanics (38.2 %) reported never being screened than members
of other racial and ethnic groups. Nearly 37 % of people with less than a high school diploma reported never being screened.
We found statistically significant differences among screening outcomes for all demographics and HBM constructs except could
not see a doctor because of costs in the last 12 months, where approximately 29 % reported no CRC screening. New interventions
should focus on those subpopulations that have never been screened for CRC.
in some populations. This study describes the characteristics of people who have never been screened for CRC. In addition,
we use the health belief model to examine the constructs associated with screening behavior. We used data from the 2010 Behavioral
Risk Factor Surveillance System (BRFSS) to create three study outcomes: people who have been screened for CRC and are up-to-date
with current recommendations, people who have been screened but are not up-to-date, and people who have never been screened.
We used multivariate logistic regression modeling to calculate predicted marginal estimates examining the associations between
the screening outcomes and demographic and Health Belief Model (HBM) characteristics. Overall 29 % of respondents had never
been screened for CRC. In the adjusted model, 36.6 % of US adults age 50–59 years and 29.1 % of US men reported never being
screened for CRC. More Asian/Native Hawaiian/Pacific Islander, non-Hispanics (38.2 %) reported never being screened than members
of other racial and ethnic groups. Nearly 37 % of people with less than a high school diploma reported never being screened.
We found statistically significant differences among screening outcomes for all demographics and HBM constructs except could
not see a doctor because of costs in the last 12 months, where approximately 29 % reported no CRC screening. New interventions
should focus on those subpopulations that have never been screened for CRC.
- Content Type Journal Article
- Category Original Paper
- Pages 1-9
- DOI 10.1007/s10900-012-9600-x
- Authors
- Sandte L. Stanley, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-52, Atlanta, GA 30341, USA
- Jessica B. King, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-52, Atlanta, GA 30341, USA
- Cheryll C. Thomas, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-52, Atlanta, GA 30341, USA
- Lisa C. Richardson, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-52, Atlanta, GA 30341, USA
- Journal Journal of Community Health
- Online ISSN 1573-3610
- Print ISSN 0094-5145