Psychosocial variables associated with colorectal cancer screening in South Australia.
BACKGROUND
Population screening reduces mortality from colorectal cancer, yet factors associated with uptake of screening are incompletely understood.


OBJECTIVE
The purpose of the study was to determine demographic and psychosocial factors associated with participation in faecal occult blood test (FOBT)-based colorectal cancer (CRC) screening in an average risk community programme in Adelaide, South Australia.


METHODS
A questionnaire consistent with the Preventive Health Model was used to determine demographic and psychosocial differences between previous FOBT-based screening participants (n = 413, response rate 93.2%) and non-participants (n = 481, response rate 47.9%). Results were analysed by univariate and multivariate generalised linear modelling, and factors associated with participation were identified.


RESULTS
Factor analysis of psychosocial items revealed an optimal three-factor solution (knowledge, faecal aversion, belief in the value of screening). Following multivariate analyses, two psychosocial and two demographic factors remained as predictors of FOBT screening behaviour: (1) items related to faecal aversion (Aversion), relative risk (RR) = 0.61, CI = 0.55-0.69, (2) perceptions about the value of screening (Value), RR = 1.45, CI = 1.13-1.85, (3) age band 65-69 (Age, five age bands, relative to age 50-54), RR = 1.43, CI = 1.16-1.76 and FOBT type (Test; three tests, Hemoccult, FlexSure, InSure randomly assigned, relative to Hemoccult: FlexSure: RR = 1.41, CI = 1.17-1.71, InSure: RR = 1.76, CI = 1.47-2.11.


CONCLUSIONS
The psychosocial factors associated with non-participation in FOBT-based CRC screening are amenable to interventions designed to improve participation. The small relative risks values associated with each predictor, however, raise the possibility that additional factors are likely to influence screening participation.
Cole
Stephen R
SR
Bowel Health Service, Repatriation General Hospital Daw Park, Daws Road, Daw Park, 5041 South Australia, Australia. steve.cole@health.sa.gov.au
Zajac
Ian
I
Gregory
Tess
T
Mehaffey
Sarah
S
Roosa
Naomi
N
Turnbull
Deborah
D
Esterman
Adrian
A
Young
Graeme P
GP
D017677:Age Distribution; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D013021:South Australia; D011795:Surveys and Questionnaires