title: Can breast and cervical cancer screening visits be used to enhance colorectal cancer screening?
abstract: OBJECTIVE
  Despite high acceptance levels of mammography and cervical cancer screening by U.S. women, adherence with colorectal cancer screening remains suboptimal. A better understanding of the relationship among cancer screening behaviors by women may provide insight into interventions to enhance colorectal cancer screening.
  
  
  METHODS
  Women 50 years and older who participated in the 2000 Behavioral Risk Factors Surveillance Survey and lived in one of the five states that administered the colorectal cancer module (Colorado, Illinois, Massachusetts, Ohio, and Utah) were queried regarding cancer screening patterns. Predictors of colorectal cancer screening were determined using multivariate analysis from sociodemographic data and non-colorectal cancer screening adherence rates (based on American Cancer Society guidelines).
  
  
  RESULTS
  Among the 1300 colorectal cancer module respondents, cancer screening adherence was significantly less for colorectal cancer (24.9%) compared with cervical cancer (57.2%) or breast cancer (78.6%). In multivariate analysis, increasing age, health insurance, adherence with cervical cancer screening (adjusted odds ratio [OR] 2.09, p < 0.01) and adherence with breast cancer screening (adjusted OR 1.89, p < 0.01) were independent predictors of colorectal cancer screening. Participants who adhered to both mammography and Pap smear guidelines were significantly more likely to adhere to colorectal cancer screening compared with women who adhered to either screening test alone (adjusted OR 1.88, p < 0.001).
  
  
  CONCLUSIONS
  Women adherent to mammography and cervical cancer screening guidelines were significantly more likely to undergo colorectal cancer screening than those who were not adherent, although colorectal cancer acceptance in the adherent group was still suboptimal. Because psychological barriers to colorectal cancer screening exist, non-colorectal cancer screening visits that women already readily accept potentially represent a setting (or "teachable moment") for the delivery of education and behavior-related interventions aimed at reducing the burden of colorectal cancer.
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109-0030, USA. rcarlos@umich.edu
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Carlos
authors.forename: A Mark
authors.initials: AM
authors.lastname: Fendrick
authors.forename: James
authors.initials: J
authors.lastname: Ellis
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000517:prevention & control*; D016009:Chi-Square Distribution; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D015999:Multivariate Analysis; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears