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Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75)

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Abstract

Purpose

To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45–75 years.

Methods

We recruited 492 self-identified males aged 45–75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can’t make ends meet, unmet material needs, and financial cutbacks. Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit.

Results

Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (β = 0.47, 95% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (β = 0.22, 95% CI: 0.11, 0.34), but was not significantly associated with subjective norms (β = 0.07, 95% CI: − 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers.

Conclusions

Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.

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Data availability

The data reported in this study are available from the corresponding author upon reasonable request. Analysis code is available on Open Science Framework: https://osf.io/9a54m/

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Acknowledgments

This project was partly supported by the Health Studies Fund, Department of Family and Preventive Medicine, University of Utah; 5 For the Fight; Huntsman Cancer Institute; the V Foundation for Cancer Research; the Medical College of Wisconsin; and the National Cancer Institute (Grant K01CA234319), an entity of the National Institutes of Health (NIH). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, 5 For the Fight, V Foundation for Cancer Research, Huntsman Cancer Institute, the Huntsman Cancer Foundation, the Medical College of Wisconsin, or the University of Utah. The authors report no other financial disclosures. The research team extends gratitude to the participants who made the study possible as well as to Eleanor Mayfield, ELS, for editorial assistance. The data reported in this study are available from the corresponding author upon reasonable request.

Funding

This project was partly supported by the Health Studies Fund, Department of Family and Preventive Medicine, University of Utah; 5 For the Fight; Huntsman Cancer Institute; the V Foundation for Cancer Research; the Medical College of Wisconsin; and the National Cancer Institute (Grant K01CA234319), an entity of the National Institutes of Health (NIH). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, 5 For the Fight, V Foundation for Cancer Research, Huntsman Cancer Institute, the Huntsman Cancer Foundation, the Medical College of Wisconsin, or the University of Utah. Department of Family and Preventive Medicine, University of Utah School of Medicine, 5 for the Fight, Huntsman Cancer Institute, V Foundation for Cancer Research,Medical College of Wisconsin, Division of Cancer Prevention, National Cancer Institute, K01CA234319.

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Authors and Affiliations

  1. Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA

    Kevin M. Korous & Charles R. Rogers

  2. Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA

    Uchenna C. Ogbonnaya & Ellen Brooks

  3. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada

    Mary A. De Vera

  4. Medical College of Georgia, Georgia Cancer Center, Cancer Prevention, Control & Population Health, Augusta University, Augusta, GA, 30912, USA

    Justin X. Moore

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  1. Kevin M. Korous
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Contributions

KMK: conceptualization; data curation; formal analysis; methodology; writing–original draft; writing—review & editing; funding acquisition; project administration. UCO: conceptualization; writing—original draft; writing—review & editing. MADV: writing–original draft; writing—review & editing. EB: conceptualization; writing—original draft; writing–review & editing; project administration. JXM: methodology; writing—original draft; writing—review & editing; funding acquisition. CRR: conceptualization; methodology; supervision; writing—original draft; writing—review & editing; funding acquisition. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kevin M. Korous.

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Competing interests

Although unrelated to this study, Dr. Charles R. Rogers offers scientific input to research studies through an investigator services agreement with Exact Sciences. The authors have no other relevant financial or non-financial interests to disclose.

Ethical approval

This study was approved by the University of Utah’s Institutional Review Board (#00149604) and conducted in line with the principles of the Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study. Individual participants consented by selecting “Yes” on the online survey after reading the online study consent cover letter.

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Korous, K.M., Ogbonnaya, U.C., De Vera, M.A. et al. Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75). Cancer Causes Control 34, 737–747 (2023). https://doi.org/10.1007/s10552-023-01713-y

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