title: Adherence to colorectal cancer screening guidelines in Canada.
abstract: BACKGROUND
  To identify correlates of adherence to colorectal cancer (CRC) screening guidelines in average-risk Canadians.
  
  
  METHODS
  2003 Canadian Community Health Survey Cycle 2.1 respondents who were at least 50 years old, without past or present CRC and living in Ontario, Newfoundland, Saskatchewan, and British Columbia were included. Outcomes, defined according to current CRC screening guidelines, included adherence to: i) fecal occult blood test (FOBT) (in prior 2 years), ii) endoscopy (colonoscopy/sigmoidoscopy) (prior 10 years), and iii) adherence to CRC screening guidelines, defined as either (i) or (ii). Generalized estimating equations regression was employed to identify correlates of the study outcomes.
  
  
  RESULTS
  Of the 17,498 respondents, 70% were non-adherent CRC screening to guidelines. Specifically, 85% and 79% were non-adherent to FOBT and endoscopy, respectively. Correlates for all outcomes were: having a regular physician (OR = (i) 2.68; (ii) 1.91; (iii) 2.39), getting a flu shot (OR = (i) 1.59; (ii) 1.51; (iii) 1.55), and having a chronic condition (OR = (i) 1.32; (ii) 1.48; (iii) 1.43). Greater physical activity, higher consumption of fruits and vegetables and smoking cessation were each associated with at least 1 outcome. Self-perceived stress was modestly associated with increased odds of adherence to endoscopy and to CRC screening guidelines (OR = (ii) 1.07; (iii) 1.06, respectively).
  
  
  CONCLUSIONS
  Healthy lifestyle behaviors and factors that motivate people to seek health care were associated with adherence, implying that invitations for CRC screening should come from sources that are independent of physicians, such as the government, in order to reduce disparities in CRC screening.
authors.affiliation: Department of Medicine, McGill University, Montreal, Canada. maida.sewitch@mcgill.ca
authors.forename: Maida J
authors.initials: MJ
authors.lastname: Sewitch
authors.forename: Caroline
authors.initials: C
authors.lastname: Fournier
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciampi
authors.forename: Alina
authors.initials: A
authors.lastname: Dyachenko
mesh_terms: D002170:Canada; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance; D012812:Sigmoidoscopy