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Colorectal Cancer Screening Among Primary Care Patients: Does Risk Affect Screening Behavior?

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Abstract

Lifestyle factors including smoking, obesity, and diabetes can increase colorectal cancer (CRC) risk. Controversy exists regarding screening rates in individuals at increased CRC risk. To examine the effect of risk on CRC screening in primary care, cross-sectional data collected during January 2006–July 2007 from 720 participants in 24 New Jersey primary care practices were analyzed. Participants were stratified by risk: high (personal/family history of CRC, history of polyps, inflammatory bowel disease), increased (obesity, Type II diabetes, current/former smokers), and average. Outcomes were up-to-date with CRC screening, receiving a physician recommendation for screening, and recommendation adherence. Chi-square and generalized linear modeling were used to determine the effect of independent variables on risk group and risk group on outcomes. Thirty-seven percent of participants were high-risk, 46% increased-risk, and 17% average-risk. Age, race, insurance, education, and health status were related to risk. High-risk participants had increased odds of being up-to-date with screening (OR 3.14 95% CI 1.85–5.32) and adhering to physician recommendation (OR 7.18 95% CI 3.58–14.4) compared to average-risk. Increased-risk participants had 32% decreased odds of screening (OR 0.68, 95% CI 0.42–1.08). Low screening rates among increased-risk individuals highlight the need for screening interventions targeting these patients.

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Acknowledgments

We are indebted to all of the participants who agreed to take part in the study, as well as the clinicians and staff members of each participating practice. We thank the New Jersey Primary Care Research Network, the SCOPE research team, and all of the SCOPE participant recruiters and research nurses. Finally, we thank the National Cancer Institute for funding this research. This manuscript is comprised of data arising from the Supporting Colorectal Outcomes through Participatory Enhancements (SCOPE) study, which is funded by the National Cancer Institute (1R01CA112387-01).

Conflict of Interest

The authors declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Family Medicine and Community Health, University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, 1 World’s Fair Drive, Suite 1500, Somerset, NJ, 08873, USA

    Christina B. Felsen, Alicja Piasecki, Jeanne M. Ferrante, Pamela A. Ohman-Strickland & Benjamin F. Crabtree

  2. The Cancer Institute of New Jersey, UMDNJ-RWJMS, New Brunswick, NJ, USA

    Jeanne M. Ferrante & Benjamin F. Crabtree

  3. Deparment of Family Medicine, UMDNJ-New Jersey Medical School, Newark, NJ, USA

    Jeanne M. Ferrante

  4. Department of Epidemiology, UMDNJ-School of Public Health, Piscataway, NJ, USA

    Pamela A. Ohman-Strickland

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  1. Christina B. Felsen
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Correspondence to Christina B. Felsen.

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Felsen, C.B., Piasecki, A., Ferrante, J.M. et al. Colorectal Cancer Screening Among Primary Care Patients: Does Risk Affect Screening Behavior?. J Community Health 36, 605–611 (2011). https://doi.org/10.1007/s10900-010-9348-0

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