Health beliefs and endoscopic screening for colorectal cancer: potential for cancer prevention.
BACKGROUND
Colorectal cancer can be prevented through endoscopic removal of adenomatous polyps. Because screening endoscopy rates are low, it is critical to identify correlates of screening behavior that are amenable to interventions to improve screening rates. Our purpose was to identify the correlates of endoscopic screening among persons at risk for colorectal cancer.


METHODS
We surveyed 1,160 healthy, adult, first-degree relatives of colorectal cancer patients in 583 kindreds, for a 43% response rate. Using multiple logistic regression analysis, we tested the association between screening behavior and perceived risk for colorectal cancer, the belief that colorectal cancer can be prevented, demographic factors, strength of family history, and practical barriers to screening.


RESULTS
Persons screened at least once were older, were male, had stronger family histories, had a regular doctor, and had health insurance. After these fixed factors were accounted for, the belief that colorectal cancer can be prevented and higher perceived risk were associated with significantly greater odds of screening.


CONCLUSIONS
This study establishes the need for trials evaluating the cancer prevention potential of the link between screening behavior and health beliefs. Physicians must be aware of their patients' family colorectal cancer history and recommend appropriate endoscopic screening for those at increased risk, particularly women. Patients should be educated about their cancer risk and about preventing colorectal cancer.
Codori
A M
AM
Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA. acodori@mail.jhmi.edu
Petersen
G M
GM
Miglioretti
D L
DL
Boyd
P
P
D000328:Adult; D001294:Attitude to Health; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged