Psychological and behavioral factors associated with colorectal cancer screening among Ashkenazim.
BACKGROUND
Psychological and behavioral factors related to annual colorectal cancer (CRC) screening were examined in a sample of Ashkenazi Jewish individuals. Identification of factors related to regular CRC screening in this population is important because of the possibility of a heightened incidence of CRC.


METHODS
Eligible participants were 171 Ashkenazi Jewish adults 40 years or older attending an educational program about breast cancer genetics. Compliance with recommended guidelines for digital rectal examination and fecal occult blood test in the past year were dependent measures. Demographic variables, family history of CRC, perceived risk, physician recommendation, and worry about cancer were independent measures.


RESULTS
Digital rectal examinations and fecal occult blood tests had been obtained in the past year by 46 and 31% of the participants, respectively. A logistic regression showed that physician recommendation was related significantly to obtaining digital rectal examinations. Physician recommendation and education were related significantly to obtaining fecal occult blood tests. Although participants with family histories of CRC perceived themselves as being at increased risk of developing CRC, and were more worried about developing colon cancer, they were no more likely to adhere to CRC screening guidelines than those without such histories.


CONCLUSIONS
Overall, compliance with recommended CRC screening was low even among high-risk individuals. Physicians play a key role in motivating people to comply with CRC screening. Physicians need to en courage all asymptomatic patients 50 years and older to be screened for CRC.
Friedman
L C
LC
Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas 77030, USA. loisf@bcm.tmc.edu
Webb
J A
JA
Richards
C S
CS
Plon
S E
SE
D000328:Adult; D015179:Colorectal Neoplasms / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007585:Jews / Q000235:genetics / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D009042:Motivation; D009780:Occult Blood; D010349:Patient Compliance / Q000208:ethnology*; D010353:Patient Education as Topic; D010808:Physical Examination; D010819:Physician's Role; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013781:Texas