title: Predictors of colorectal screening in rural Colorado: testing to prevent colon cancer in the high plains research network.
abstract: BACKGROUND
  Colorectal cancer is the second leading cause of cancer death in the United States, yet screening rates are well below target levels. Rural communities may face common and unique barriers to health care, particularly preventive health care.
  
  
  OBJECTIVE
  To establish baseline attitudinal, knowledge, belief, and behavior measures on colorectal cancer screening and to identify barriers to or predictors of colorectal cancer screening.
  
  
  METHODS
  As part of a controlled trial using a quasi-experimental, pretest, post-test design, we conducted a baseline telephone survey of 1,050 rural eastern Colorado residents aged 50 years and older. Smaller counties were over-sampled to ensure a minimum of 30 completed interviews per county.
  
  
  RESULTS
  Seventy-seven percent reported they ever had a colorectal cancer screening test and 59% were up-to-date on at least 1 test. The most important independent predictors of being up-to-date were having visited a doctor or other health care practitioner for a checkup in the past year, having personal or family history of colon polyps or cancer, and having asked for a colorectal cancer screening test. Financial concerns were reported reasons for not obtaining fecal occult blood testing by 18% and colonoscopy by 21%.
  
  
  CONCLUSIONS
  This study suggests that health care providers should be vigilant in counseling their patients 50 and older to have a colorectal cancer test. Community programs designed to promote colon cancer screening should encourage residents to have regular contact with their primary care physician and ask their doctor for a screening test. Additionally, programs should provide financial assistance for testing for low-income and uninsured patients.
authors.affiliation: Department of Family Medicine, University of Colorado at Denver and Health Sciences Center, Aurora, CO 80045-0508, USA.
authors.forename: Walter F
authors.initials: WF
authors.lastname: Young
authors.forename: Joe
authors.initials: J
authors.lastname: McGloin
authors.forename: Linda
authors.initials: L
authors.lastname: Zittleman
authors.forename: David R
authors.initials: DR
authors.lastname: West
authors.forename: John M
authors.initials: JM
authors.lastname: Westfall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000706:statistics & numerical data; D003120:Colorado; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012423:Rural Health; D012812:Sigmoidoscopy / Q000706:statistics & numerical data; D012959:Socioeconomic Factors