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Psychosocial Variables Associated with Colorectal Cancer Screening in South Australia

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Abstract

Background

Population screening reduces mortality from colorectal cancer, yet factors associated with uptake of screening are incompletely understood.

Purpose

The purpose of the study was to determine demographic and psychosocial factors associated with participation in faecal occult blood test (FOBT)-based colorectal cancer (CRC) screening in an average risk community programme in Adelaide, South Australia.

Method

A questionnaire consistent with the Preventive Health Model was used to determine demographic and psychosocial differences between previous FOBT-based screening participants (n = 413, response rate 93.2%) and non-participants (n = 481, response rate 47.9%). Results were analysed by univariate and multivariate generalised linear modelling, and factors associated with participation were identified.

Results

Factor analysis of psychosocial items revealed an optimal three-factor solution (knowledge, faecal aversion, belief in the value of screening). Following multivariate analyses, two psychosocial and two demographic factors remained as predictors of FOBT screening behaviour: (1) items related to faecal aversion (Aversion), relative risk (RR) = 0.61, CI = 0.55–0.69, (2) perceptions about the value of screening (Value), RR = 1.45, CI = 1.13–1.85, (3) age band 65–69 (Age, five age bands, relative to age 50–54), RR = 1.43, CI = 1.16–1.76 and FOBT type (Test; three tests, Hemoccult®, FlexSure®, InSure® randomly assigned, relative to Hemoccult®: FlexSure®: RR = 1.41, CI = 1.17–1.71, InSure®: RR = 1.76, CI = 1.47–2.11.

Conclusions

The psychosocial factors associated with non-participation in FOBT-based CRC screening are amenable to interventions designed to improve participation. The small relative risks values associated with each predictor, however, raise the possibility that additional factors are likely to influence screening participation.

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Acknowledgements

Professor Carlene Wilson, for critical comments and suggestions during the preparation of this manuscript.

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Authors and Affiliations

  1. Bowel Health Service, Repatriation General Hospital Daw Park, Daws Road, Daw Park, 5041, South Australia, Australia

    Stephen R. Cole & Sarah Mehaffey

  2. School of Psychology, University of Adelaide, Adelaide, 5000, South Australia, Australia

    Ian Zajac, Tess Gregory, Naomi Roosa & Deborah Turnbull

  3. School of Nursing and Midwifery, University of South Australia, Adelaide, 5000, South Australia, Australia

    Adrian Esterman

  4. Flinders Centre for Cancer Prevention and Control, Flinders University, Bedford Park, 5042, South Australia, Australia

    Stephen R. Cole, Ian Zajac, Tess Gregory & Graeme P. Young

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  1. Stephen R. Cole
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Correspondence to Stephen R. Cole.

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Cole, S.R., Zajac, I., Gregory, T. et al. Psychosocial Variables Associated with Colorectal Cancer Screening in South Australia. Int.J. Behav. Med. 18, 302–309 (2011). https://doi.org/10.1007/s12529-010-9101-1

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  • DOI: https://doi.org/10.1007/s12529-010-9101-1

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