Cultural, Economic, and Psychological Predictors of Colonoscopy in a National Sample
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Although colorectal cancer (CRC) is the second leading cause of cancer death among adults in the US and colonoscopy is efficacious in reducing morbidity and mortality from CRC, screening rates are sub-optimal. Understanding the socioeconomic, cultural, and health care context within which decisions about colonoscopy are made allows physicians to address patients’ most salient beliefs and values and other constraints when making screening recommendations.
To evaluate the direct and interactive effects of socioeconomics, health care variables, psychological characteristics, and cultural values on colonoscopy use.
Design, Setting, Participants
National survey completed between January-August 2009 in a random sample of African American, white, and Hispanic adults ages 50–75 without cancer (n = 582).
Self-reported colonoscopy use.
Only 59% of respondents reported having a colonoscopy. The likelihood of colonoscopy increased with having health insurance (OR = 2.82, 95% CI = 1.24, 6.43, p = 0.004), and increasing age (OR = 1.40, 95% CI = 1.11, 1.77, p = 0.001). In addition, respondents with greater self-efficacy were more likely to have a colonoscopy (OR = 2.41, 95% CI = 1.35, 4.29, p = 0.003).
Programs that help patients to overcome access and psychological barriers to screening are needed.
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- Cultural, Economic, and Psychological Predictors of Colonoscopy in a National Sample
Journal of General Internal Medicine
Volume 26, Issue 11 , pp 1311-1316
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- Author Affiliations
- 1. Department of Psychiatry, Center for Community-Based Research, University of Pennsylvania, Philadelphia, PA, USA
- 2. Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
- 7. Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA
- 3. Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA
- 4. Department of Medicine, Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
- 5. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- 6. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA