Journal of General Internal Medicine

, 26:1311

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

Authors

    • Department of Psychiatry, Center for Community-Based ResearchUniversity of Pennsylvania
    • Abramson Cancer CenterUniversity of Pennsylvania
    • Department of Psychiatry, Center for Community-Based Research and Health DisparitiesUniversity of Pennsylvania
  • Frances K. Barg
    • Abramson Cancer CenterUniversity of Pennsylvania
    • Department of Family Medicine and Community HealthUniversity of Pennsylvania
  • Carmen E. Guerra
    • Abramson Cancer CenterUniversity of Pennsylvania
    • Department of Medicine, Division of General Internal MedicineUniversity of Pennsylvania
  • Judy A. Shea
    • Department of Medicine, Division of General Internal MedicineUniversity of Pennsylvania
  • Katrina Armstrong
    • Abramson Cancer CenterUniversity of Pennsylvania
    • Department of Medicine, Division of General Internal MedicineUniversity of Pennsylvania
  • Monica Ferguson
    • Department of Medicine, Division of General Internal MedicineUniversity of Pennsylvania
  • Benita Weathers
    • Department of Psychiatry, Center for Community-Based ResearchUniversity of Pennsylvania
  • James Coyne
    • Abramson Cancer CenterUniversity of Pennsylvania
    • Department of PsychiatryUniversity of Pennsylvania
  • Andrea B. Troxel
    • Department of Biostatistics and EpidemiologyUniversity of Pennsylvania
Original Research

DOI: 10.1007/s11606-011-1783-9

Cite this article as:
Halbert, C.H., Barg, F.K., Guerra, C.E. et al. J GEN INTERN MED (2011) 26: 1311. doi:10.1007/s11606-011-1783-9

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.

KEY WORDS

colonoscopyracialeconomicpredictorsnational survey

Copyright information

© Society of General Internal Medicine 2011