Journal of Cancer Education

, 24:225 | Cite as

Colorectal cancer knowledge is not associated with screening compliance or intention

  • David S. Weinberg
  • Suzanne Miller
  • Michelle Rodoletz
  • Brian Egleston
  • Linda Fleisher
  • Joanne Buzaglo
  • Eileen Keenan
  • Jaime Marks
  • Eric Bieber


Background. Increasing colorectal cancer (CRC) screening is a public health goal. We hypothesized that non-compliant, average risk women would demonstrate low levels of CRC knowledge and underestimate their CRC risk. Methods. Participants identified prior to routine gynecological visits completed a survey assessing demographics, CRC knowledge, risk perception, and screening intention. Results. The 318 participants demonstrated high levels of CRC knowledge. The majority estimated their risk incorrectly and had no intention of screening participation in the future. There were no consistent relationships between knowledge, risk perception, and screening intent. Conclusions. Knowledge alone is an inadequate stimulus of screening adherence.


  1. 1.
    Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2007. CA Cancer J Clin. 2007;57:43–66.CrossRefPubMedGoogle Scholar
  2. 2.
    Weinberg DS. In the clinic. Colorectal cancer screening. Ann Intern Med. 2008;148:ITC2-1–ITC2-16.Google Scholar
  3. 3.
    Sarfaty M, Wender R. How to increase colorectal cancer screening rates in practice. CA Cancer J Clin. 2007;57:354–366.CrossRefPubMedGoogle Scholar
  4. 4.
    Pignone M, Rich M, Teutsch SM, et al. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:132–141.PubMedGoogle Scholar
  5. 5.
    Society AC. Cancer Prevention and Detection: Facts and Figures. Atlanta: American Cancer Society; 2007.Google Scholar
  6. 6.
    Meissner HI, Breen N, Klabunde CN, et al. Patterns of colorectal cancer screening uptake among men and women in the United States. Cancer Epidemiol Biomarkers Prev. 2006;15:389–394.CrossRefPubMedGoogle Scholar
  7. 7.
    Healthy People 2010 Mid-Course Review: Cancer. McLean: International Medical Publishing; 2006.Google Scholar
  8. 8.
    Klabunde CN, Vernon SW, Nadel MR, et al. Barriers to colorectal cancer screening: a comparison of reports from primary care physicians and average-risk adults. Med Care. 2005;43:939–944.CrossRefPubMedGoogle Scholar
  9. 9.
    Straus WL, Mansley EC, Gold KF, et al. Colorectal cancer screening attitudes and practices in the general population: a risk-adjusted survey. J Public Health Manag Pract. 2005;11:244–251.PubMedGoogle Scholar
  10. 10.
    Ford JS, Coups EJ, Hay JL. Knowledge of colon cancer screening in a national probability sample in the United States. J Health Commun. 2006;11(Suppl 1):19–35.CrossRefPubMedGoogle Scholar
  11. 11.
    Beeker C, Kraft JM, Southwell BG, et al. Colorectal cancer screening in older men and women: qualitative research findings and implications for intervention. J Community Health. 2000;25:263–278.CrossRefPubMedGoogle Scholar
  12. 12.
    Wilcox S, Stefanick M. Knowledge and perceived risk of major diseases in middle-aged and older women. Health Psychol. 1999;18 246–353.CrossRefGoogle Scholar
  13. 13.
    Weinberg DS, Turner BJ, Wang H, et al. A survey of women regarding factors affecting colorectal cancer screening compliance. Prev Med. 2004;38:669–675.CrossRefPubMedGoogle Scholar
  14. 14.
    Seeff LC, Nadel MR, Klabunde CN, et al. Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer. 2004;100:2093–2103.CrossRefPubMedGoogle Scholar
  15. 15.
    Lipkus IM, Skinner CS, Green LS, et al. Modifying attributions of colorectal cancer risk. Cancer Epidemiol Biomarkers Prev. 2004;13:560–566.PubMedGoogle Scholar
  16. 16.
    Harewood GC, Wiersema MJ, Melton LJ, 3rd. A prospective, controlled assessment of factors influencing acceptance of screening colonoscopy. Am J Gastroenterol. 2002;97:186–3194.Google Scholar
  17. 17.
    Horton JA, Cruess DF, Pearse WH. Primary and preventive care services provided by obstetrician-gynecologists. Obstet Gynecol. 1993;82:723–726.PubMedGoogle Scholar
  18. 18.
    Weinrich SP, Weinrich MC, Boyd MD, et al. Knowledge of colorectal cancer among older persons. Cancer Nurs. 1992;15:322–330.CrossRefPubMedGoogle Scholar
  19. 19.
    Prochaska J, DiClemente C. Toward a comprehensive model of change. In: Miller W, Healther N, eds. Treating Addictive Behaviors: Process of Change, New York: Plenum Press; 1986:3–27.Google Scholar
  20. 20.
    Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992; 47:1102–1114.CrossRefPubMedGoogle Scholar
  21. 21.
    Prochaska JO, Redding CA, Harlow LL, et al. The transtheoretical model of change and HIV prevention: a review. Health Educ Q. 1994;21:471–486.PubMedGoogle Scholar
  22. 22.
    Rakowski W. The potential variances of tailoring in health behavior interventions. Ann Behav Med. 1999;21:284–289.CrossRefPubMedGoogle Scholar
  23. 23.
    Radloff L. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measure. 1977;1:385–401.CrossRefGoogle Scholar
  24. 24.
    Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41:209–218.PubMedGoogle Scholar
  25. 25.
    Miller SM. Monitoring versus blunting styles of coping with cancer influence the information patients want and need about their disease. Implications for cancer screening and management. Cancer. 1995;76:167–177.CrossRefPubMedGoogle Scholar
  26. 26.
    Harrell F. Regression Modeling Strategies. New York: Springer; 2001.Google Scholar
  27. 27.
    Raghunathan T. A multivariate technique for multiply imputing missing values using a sequence of regression models. Survey Methodology 2001;27:85–95.Google Scholar
  28. 28.
    Steptoe A. An abbreviated version of the Miller Behavioral Style Scale. Br J Clin Psychol. 1989;28(Pt 2):183–184.PubMedGoogle Scholar
  29. 29.
    Hughes E, McCracken M, Roberts H, et al. Surveillance for certain health behaviors among states and selected local areas—behavioral risk factor surveillance system, United States, 2004. M M W W R Surveill Summ. 2006;55:1–124.Google Scholar
  30. 30.
    Donovan JM, Syngal S. Colorectal cancer in women: an underappreciated but preventable risk. J Womens Health. 1998;7:45–48.CrossRefPubMedGoogle Scholar
  31. 31.
    Stockwell DH, Woo P, Jacobson BC, et al. Determinants of colorectal cancer screening in women undergoing mammography. Am J Gastroenterol. 2003;98:1875–1880.CrossRefPubMedGoogle Scholar
  32. 32.
    Turner BJ, Weiner M, Berry SD, et al. Overcoming poor attendance to first scheduled colonoscopy: a randomized trial of peer coach or brochure support. J Gen Intern Med. 2008;23:58–63.CrossRefPubMedGoogle Scholar
  33. 33.
    Ko CW, Riffle S, Shapiro JA, et al. Incidence of minor complications and time lost from normal activities after screening or surveilance colonoscopy. Gastrointest Endosc. 2007;65:648–656.CrossRefPubMedGoogle Scholar
  34. 34.
    van Dijk S, Otten W, van Asperen CJ, et al. Feeling at risk: how women interpret their familial breast cancer risk. Am J Med Genet A. 2004;131:42–49.CrossRefPubMedGoogle Scholar
  35. 35.
    Bloom JR, Stewart SL, Oakley-Girvans I, et al. Family history, perceived risk, and prostate cancer screening among African American men. Cancer Epidemiol Biomarkers Prev. 2006;15:2167–2173.CrossRefPubMedGoogle Scholar
  36. 36.
    Thompson RS, Michnich ME, Gray J, et al. Maximizing compliance with hemoccult screening for colon cancer in clinical practice. Med Care. 1986;24:904–914.CrossRefPubMedGoogle Scholar
  37. 37.
    Miller S, Kruus L. Tuning in and tuning out: confronting the effects of confrontation. In: Krohne H, ed. Attention and Avoidance. Seattle: Hogrefe & Huber; 1993:51–69.Google Scholar
  38. 38.
    Halvorsen PA, Selmer R, Kristiansen IS. Different ways to describe the benefits of risk-reducing treatments: a randomized trial. Ann Intern Med. 2007;146:848–856.PubMedGoogle Scholar
  39. 39.
    Woloshin S, Schwartz LM, Welch HG. The effectiveness of a primer to help people understand risk: two randomized trials in distinct populations. Ann Intern Med. 2007;146:256–265.PubMedGoogle Scholar
  40. 40.
    Lipkus IM, Rimer BK, Halabi S, et al. Can tailored interventions increase mammography use among HMO women? Am J Prev Med. 2000;18:1–10.CrossRefPubMedGoogle Scholar
  41. 41.
    McQueen A, Vernon SW, Meissner HI, et al. Are there gender differences in colorectal cancer test use prevalence and correlates? Cancer Epide miol Biomarkers Prev. 2006;15:782–791.CrossRefGoogle Scholar
  42. 42.
    Nadel MR, Shapiro JA, Klabunde CN, et al. A national survey of primary care physicians’ methods for screening for fecal occult blood. Ann Intern Med. 2005;142:86–94.PubMedGoogle Scholar

Copyright information

© American Association for Cancer Education 2009

Authors and Affiliations

  • David S. Weinberg
    • 1
  • Suzanne Miller
    • 1
  • Michelle Rodoletz
    • 1
  • Brian Egleston
    • 1
  • Linda Fleisher
    • 1
  • Joanne Buzaglo
    • 1
  • Eileen Keenan
    • 1
  • Jaime Marks
    • 1
  • Eric Bieber
    • 2
  1. 1.Department of MedicineFox Chase Cancer CenterPhiladelphia
  2. 2.Geisinger Health SystemDanville

Personalised recommendations