No association between colorectal cancer worry and screening uptake in Appalachian Ohio.
BACKGROUND
Limited data are available on the association between colorectal cancer (CRC) worry and CRC screening uptake, particularly in rural and underserved populations where there is an excess burden of CRC.


METHODS
Between September 2009 and March 2010, we conducted a cross-sectional study among a randomly selected sample of Appalachian Ohio residents aged 51-75 years (n= 1084). We also reviewed their medical records. Multivariable-adjusted models examined the association between CRC worry and screening by medical record review, assessed effect modification by CRC worry and determined the correlates of higher CRC worry.


RESULTS
Approximately 50% of participants were adherent to CRC screening guidelines. There was no significant association between higher CRC worry and screening adherence [odds ratio (OR) = 1.32, 95% confidence interval (CI): 0.86-2.02]. CRC worry did not modify the association between any covariate and screening adherence. Participants who were unemployed/disabled (OR = 2.15, 95% CI: 1.34-3.45) and had higher CRC risk perception (OR = 3.49, 95% CI: 2.19-5.56) had higher odds of moderate-to-extreme worry.


CONCLUSIONS
These findings highlight the need for meaningful exploration of why higher CRC worry is not associated with adherence to CRC screening, particularly in rural, medically underserved populations. Development and implementation of interventions to increase CRC screening in such areas is a significant public health priority.
Division of Population Sciences, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA Department of Epidemiology, RBHS-School of Public Health and the Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
Adana A
AA
Llanos
Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA.
Michael L
ML
Pennell
Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
Gregory S
GS
Young
Division of Population Sciences, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Cathy M
CM
Tatum
Division of Population Sciences, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA.
Mira L
ML
Katz
Division of Population Sciences, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
Electra D
ED
Paskett
D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology*
cancer; communities; screening