Original Article

Annals of Behavioral Medicine

, Volume 40, Issue 2, pp 205-217

First online:

Examining the Role of Perceived Susceptibility on Colorectal Cancer Screening Intention and Behavior

  • Amy McQueenAffiliated withDivision of Health Behavior Research, Washington University, School of Medicine Email author 
  • , Sally W. VernonAffiliated withCenter for Health Promotion and Prevention Research, University of Texas, School of Public Health
  • , Alexander J. RothmanAffiliated withDepartment of Psychology, University of Minnesota
  • , Gregory J. NormanAffiliated withDepartment of Family and Preventive Medicine, University of California at San Diego, School of Medicine
  • , Ronald E. MyersAffiliated withDepartment of Medicine, Thomas Jefferson University
  • , Barbara C. TilleyAffiliated withDepartment of Biometery and Epidemiology, University of Texas, School of Public Health

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Although support exists for multiple psychosocial predictors of colorectal cancer (CRC) screening, little is known about the relationships among these variables. Understanding the associations between such predictors could refine health behavior theories and inform the design of interventions. In addition to direct effects, we examined whether baseline perceived susceptibility was a moderator of, or was mediated by, changes in other psychosocial determinants of CRC screening intention and behavior. Longitudinal path models were tested using data from 1,001 white male automotive workers who participated in The Next Step Trial. Our sample included workers with no history of CRC who were due for CRC screening but did not complete CRC screening prior to the assessment of hypothesized mediators at year 1 follow-up. Perceived susceptibility interacted differently with four psychosocial constructs in models predicting CRC screening intention or behavior. Perceived susceptibility was independent of perceived benefits, moderated the change in perceived barriers and self-efficacy, and was mediated by the change in family influence. The role of perceived susceptibility was not limited to direct effects but involved mediating and moderating pathways of influence.


Colorectal cancer Perceived susceptibility Screening