title: Factors associated with intentions to adhere to colorectal cancer screening follow-up exams.
abstract: BACKGROUND
  To increase adherence rate to recommendations for follow-up after abnormal colorectal cancer (CRC) screening results, factors that inhibit and facilitate follow-up must be identified. The purpose of this study was to identify the factors associated with intention to adhere to CRC screening follow-up exams.
  
  
  METHODS
  During a 4-week period in October 2003, this survey was conducted with 426 subjects participating in a community-based CRC screening program in Nagano, Japan. Study measures included intention to adhere to recommendation for clinical follow-up in the event of an abnormal fecal occult blood test (FOBT) result, perceived susceptibility and severity of CRC, perceived benefits and barriers related to undergoing follow-up examination, social support, knowledge of CRC risk factors, health status, previous CRC screening, personality and social demographic characteristics. Univariate and multivariate logistic regression analyses on intention to adhere to recommendations for follow-up were performed.
  
  
  RESULTS
  Among the 288 individuals analyzed, approximately 74.7% indicated that they would definitely adhere to recommendations for follow-up. After controlling for age, gender, marital status, education, economic status, trait anxiety, bowel symptoms, family history of CRC, and previous screening FOBT, analyses revealed that lower levels of perceived barriers, higher levers of perceived benefits and knowledge of CRC risk factors were significantly associated with high intention respectively.
  
  
  CONCLUSIONS
  The results of this study suggest that future interventions should focus on reducing modifiable barriers by clarifying misperceptions about follow-up, promoting the acceptance of complete diagnostic evaluations, addressing psychological distress, and making follow-up testing more convenient and accessible. Moreover, educating the public regarding the risk factors of CRC and increasing understanding of the benefits of follow-up is also important.
authors.affiliation: Department of Social Gerontology, School of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 Japan. teiyf-tky@umin.ac.jp
authors.forename: Ying-Fang
authors.initials: YF
authors.lastname: Zheng
authors.forename: Tami
authors.initials: T
authors.lastname: Saito
authors.forename: Miyako
authors.initials: M
authors.lastname: Takahashi
authors.forename: Teruo
authors.initials: T
authors.lastname: Ishibashi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kai
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology; D003153:Community Health Services; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D033182:Intention; D007564:Japan; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D009780:Occult Blood; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010808:Physical Examination; D018570:Risk Assessment; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires