title: Association of marital status and colorectal cancer screening participation in the USA.
abstract: OBJECTIVE
  In the USA, for both men and women, colorectal cancer (CRC) ranks third in incidence and second in mortality. Despite evidence that it decreases mortality, CRC screening in the USA remains under-utilized. Some European studies have suggested that marital status affects participation in CRC screening, but the effect of marital status on CRC screening participation in the USA is unknown. In this study, the aim was to compare CRC screening participation rates among married and unmarried couples, separated, widowed, never married and divorced adults living in the USA.
  
  
  METHODS
  This was a retrospective data analysis of the 2010 Behavioural Risk Factor Surveillance System survey. The population studied included 239,300 participants, aged 50-75 years, who completed the 2010 survey. Logistic regression analysis was conducted to assess the association between adherence with CRC screening guidelines and marital status while accounting for survey stratum/weight and covariates.
  
  
  RESULTS
  Individuals who were divorced or separated, never married or widowed had decreased odds of adherence with CRC screening guidelines compared with individuals who were married and unmarried couples.
  
  
  CONCLUSIONS
  In this study, individuals living in the USA who were married and unmarried couples had increased odds of undergoing CRC screening compared to individuals in other marital status groups. Public health interventions are needed to promote CRC screening participation in these other groups.
authors.affiliation: Department of Internal Medicine, University of Kansas School of Medicine, Wichita, Kansas, USA.
authors.forename: B
authors.initials: B
authors.lastname: El-Haddad
authors.forename: F
authors.initials: F
authors.lastname: Dong
authors.forename: K J
authors.initials: KJ
authors.lastname: Kallail
authors.forename: R B
authors.initials: RB
authors.lastname: Hines
authors.forename: E
authors.initials: E
authors.lastname: Ablah
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D004243:Divorce / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008393:Marriage / Q000706:statistics & numerical data; D008875:Middle Aged; D009780:Occult Blood; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D017805:Widowhood / Q000706:statistics & numerical data
keywords: Marital status; colorectal cancer screening; early detection of cancer