title: Colorectal cancer screening among midwestern community-based residents: indicators of success.
abstract: Screening reduces the rate of death and morbidity resulting from CRC. Although CRC screening rates are low relative to other cancer screening tests, rates appear to be increasing: In 2004, 57% of adults > or =50 years reported up-to-date CRC screening test use; 14 states and Washington DC showed rates in excess of 60%. Identification of indicators of success and challenges remaining are important for universal goal achievement. The purpose of this study was to identify system and individual-level indicators of up-to-date CRC screening in a geographic area that reports higher uptake rates. Random-digit-dialing methods were used to survey a population-based community sample (N = 1033) of Midwestern adults ages 50 to 79 for CRC screening uptake in spring 2005. Adjusted odds ratio estimates were obtained using multivariate logistic regression. In total, about 62.6% of the sample reported up-to-date CRC screening. Compliant attitudes toward physicians' screening recommendations were important indicators for up-to-date CRC screening; other individual-level psychosocial factors included beliefs about testing responsibility and testing safety. Non-current CRC screening was linked with testing anxiety and lack of perceived need for healthy people to test. System-level indicators associated with up-to-date CRC screening included reliance on physicians as the primary source for health information, family/personal history of bowel disease, regular physician visits, and participation in other cancer screening tests, controlling for age. Although population-based studies generally emphasize health system-level factors, individual-level attitudes such as feelings of responsibility to screen and adherence to physicians' screening recommendations are important contributors to up-to-date CRC screening patterns.
authors.affiliation: Center for Patient Care & Outcomes Research, Medical College of Wisconsin, Suite H2755 8701 Watertown Plank Road, P.O. Box 26509, Milwaukee, WI 53226-0509, USA.
authors.forename: B Alex
authors.initials: BA
authors.lastname: Matthews
authors.forename: Ann B
authors.initials: AB
authors.lastname: Nattinger
authors.forename: Thangam
authors.initials: T
authors.lastname: Venkatesan
authors.forename: Reza
authors.initials: R
authors.lastname: Shaker
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015146:Midwestern United States; D015397:Program Evaluation