Abstract
The study examines the role of patient colorectal cancer (CRC) screening test preference and CRC screening uptake in an insured, urban minority population. Study subjects were enrolled in a randomized controlled trial to promote CRC screening. The interventions were educational, with an emphasis on colonoscopy screening. Subjects were 50+ years of age, fully insured for CRC screening, and out of compliance with current CRC screening recommendations. This paper includes those who answered a question about CRC screening test preference and indicated that they intended to receive such a test in the coming year (n = 453). CRC screening uptake was ascertained from medical claims data. Regardless of test preference, few received CRC screening (22.3 %). Those preferring the home stool test (HST) were less likely to get tested than those preferring a colonoscopy (16.6 vs 29.9 %, χ2 = 9.9, p = .002). Preference for HST was more strongly associated with beliefs about colonoscopy than with knowledge about colonoscopy. In the context of an RCT emphasizing colonoscopy screening for CRC, patients expressing a preference for HST are at heightened risk of remaining unscreened. Colonoscopy should be recommended as the preferred CRC test, but HSTs should be accessible and encouraged for patients who are averse to colonoscopy.
Clinical trials.gov: Identifier: NCT02392143.
Similar content being viewed by others
References
Klabunde, C. N., Cronin, K. A., Breen, N., Waldron, W. R., Ambs, A. H., & Nadel, M. R. (2011). Trends in colorectal cancer test use among vulnerable populations in the United States. Cancer Epidemiology Biomarkers & Prevention, 20(8), 1611–1621.
Klabunde, C. N., Joseph, D. A., King, J. B., White, A., & Plescia, M. (2013). Vital signs: Colorectal cancer screening test use–United States, 2012. Morbidity and Mortality Weekly Report, 62(44), 881–888.
Gawron, A. J., & Yadlapati, R. (2014). Disparities in endoscopy use for colorectal cancer screening in the United States. Digestive Diseases and Sciences, 59(3), 530–537.
Levin, B., Lieberman, D. A., Mcfarland, B., et al. (2008). Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA: A Cancer Journal for Clinicians, 58(3), 130–160.
Rex, D. K., Johnson, D. A., Anderson, J. C., et al. (2009). American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. American Journal of Gastroenterology, 104(3), 739–750.
Preventive, U. S. (2008). Services task force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 149(9), 627–637.
Wolf, M. S., Baker, D. W., & Makoul, G. (2007). Physician-patient communication about colorectal cancer screening. Journal of General Internal Medicine, 22(11), 1493–1499.
Mcqueen, A., Bartholomew, L. K., Greisinger, A. J., et al. (2009). Behind closed doors: Physician-patient discussions about colorectal cancer screening. Journal of General Internal Medicine, 24(11), 1228–1235.
Gupta, S., Sussman, D. A., Doubeni, C. A., et al. (2014). Challenges and possible solutions to colorectal cancer screening for the underserved. Journal of the National Cancer Institute, 106(4), dju032.
Richards, C. A., Kerker, B. D., Thorpe, L., et al. (2011). Increased screening colonoscopy rates and reduced racial disparities in the New York Citywide campaign: An urban model. American Journal of Gastroenterology, 106(11), 1880–1886.
Steinwachs, D., Allen, J. D., Barlow, W. E., et al. (2010). National Institutes of Health state-of-the-science conference statement: Enhancing use and quality of colorectal cancer screening. Annals of Internal Medicine, 152(10), 663–667.
Basch, C. E., Zybert, P., Wolf, R. L., et al. (2015). Randomized trial to compare alternative educational interventions to increase colorectal cancer screening in a hard-to-reach urban minority population with health insurance. Journal of Community Health, 40(5), 975–983.
American Cancer Society. (2015). Colorectal cancer facts and figures 2011–2013. Atlanta: American Cancer Society. American Cancer Society Web Site. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-028312.pdf. Accessed June 14, 2015.
The New York City Quality Benchmarking Group. (2015). New York City Department of Health Web Site. http://www.nyc.gov/html/doh/downloads/pdf/cancer/colonoscopy-brochure.pdf. Accessed June 14, 2015.
Zettler, M., Mollon, B., da silva, V., Howe, B., Speechley, M., & Vinden, C. (2010). Family physicians’ choices of and opinions on colorectal cancer screening modalities. Canadian Family Physician, 56(9), 338–344.
Basch, C. E., Wolf, R. L., Brouse, C. H., et al. (2006). Telephone outreach to increase colorectal cancer screening in an urban minority population. American Journal of Public Health, 96(12), 2246–2253.
Myers, R. E., Sifri, R., Daskalakis, C., et al. (2014). Increasing colon cancer screening in primary care among African Americans. Journal of the National Cancer Institute, 106(12), dju344.
Lawson, G., Basch, C. H., Zybert, P., Wolf, R. L., & Basch, C. E. (in press). Applying the RESPECT approach to health education to physician-directed academic detailing to increase practice-wide colorectal cancer screening uptake. Health Promotion Perspectives.
Hawley, S. T., Mcqueen, A., Bartholomew, L. K., et al. (2012). Preferences for colorectal cancer screening tests and screening test use in a large multispecialty primary care practice. Cancer, 118(10), 2726–2734.
Schroy, P. C., Lal, S., Glick, J. T., Robinson, P. A., Zamor, P., & Heeren, T. C. (2007). Patient preferences for colorectal cancer screening: how does stool DNA testing fare? The American Journal of Managed Care, 13(7), 393–400.
Inadomi, J. M., Vijan, S., Janz, N. K., et al. (2012). Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Archives of Internal Medicine, 172(7), 575–582.
Wolf, R. L., Basch, C. E., Brouse, C. H., Shmukler, C., & Shea, S. (2006). Patient preferences and adherence to colorectal cancer screening in an urban population. American Journal of Public Health, 96(5), 809–811.
Basch, C. H., Basch, C. E., Zybert, P., & Wolf, R. L. (in press). Barriers to colonoscopy screening in an urban population with health insurance. Journal of Cancer Education.
Rogers, E. (2003). Diffusion of innovations (5th ed.). New York: Simon and Schuster.
American Cancer Society. (2015). 2015 Communications Guidebook: Effective messaging to reach the unscreened: 80% by 2018. http://nccrt.org/wp-content/uploads/CRC-Communications-Guidebook-final-v4-02232015.pdf. Accessed June 14, 2015.
Zauber, A. G., Lansdorp-Vogelaar, I., Knudsen, A. B., Wilschut, J., van Ballegooijen, M., & Kuntz, K. M. (2008). Evaluating test strategies for colorectal cancer screening: A decision analysis for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 149(9), 659–669.
Acknowledgments
This work was supported by the American Cancer Society (Grant number RSFT-09-012-01-CPPB).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wolf, R.L., Basch, C.E., Zybert, P. et al. Patient Test Preference for Colorectal Cancer Screening and Screening Uptake in an Insured Urban Minority Population. J Community Health 41, 502–508 (2016). https://doi.org/10.1007/s10900-015-0123-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-015-0123-0