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Cultural, Economic, and Psychological Predictors of Colonoscopy in a National Sample

  • Original Research
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Abstract

Background

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.

Objective

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).

Main Measure

Self-reported colonoscopy use.

Key Results

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).

Conclusions

Programs that help patients to overcome access and psychological barriers to screening are needed.

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Contributors

We would like to acknowledge Abt/SBRI for completing telephone interviews. We are very appreciative to the men and women who participated in this research.

Funders

This research was supported by National Cancer Institute grant #R01-CA100254.

Prior Presentations

None.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Center for Community-Based Research, University of Pennsylvania, Philadelphia, PA, USA

    Chanita Hughes Halbert PhD & Benita Weathers MPH

  2. Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA

    Chanita Hughes Halbert PhD, Frances K. Barg PhD, Carmen E. Guerra MD, Katrina Armstrong MD & James Coyne PhD

  3. Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA

    Frances K. Barg PhD

  4. Department of Medicine, Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Carmen E. Guerra MD, Judy A. Shea PhD, Katrina Armstrong MD & Monica Ferguson MD

  5. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA

    James Coyne PhD

  6. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA

    Andrea B. Troxel ScD

  7. Department of Psychiatry, Center for Community-Based Research and Health Disparities, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA

    Chanita Hughes Halbert PhD

Authors
  1. Chanita Hughes Halbert PhD
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  2. Frances K. Barg PhD
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  4. Judy A. Shea PhD
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  6. Monica Ferguson MD
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  7. Benita Weathers MPH
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Corresponding author

Correspondence to Chanita Hughes Halbert PhD.

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Halbert, C.H., Barg, F.K., Guerra, C.E. et al. Cultural, Economic, and Psychological Predictors of Colonoscopy in a National Sample. J GEN INTERN MED 26, 1311–1316 (2011). https://doi.org/10.1007/s11606-011-1783-9

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  • DOI: https://doi.org/10.1007/s11606-011-1783-9

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