title: Patient Test Preference for Colorectal Cancer Screening and Screening Uptake in an Insured Urban Minority Population.
abstract: The study examines the role of patient colorectal cancer (CRC) screening test preference and CRC screening uptake in an insured, urban minority population. Study subjects were enrolled in a randomized controlled trial to promote CRC screening. The interventions were educational, with an emphasis on colonoscopy screening. Subjects were 50+ years of age, fully insured for CRC screening, and out of compliance with current CRC screening recommendations. This paper includes those who answered a question about CRC screening test preference and indicated that they intended to receive such a test in the coming year (n = 453). CRC screening uptake was ascertained from medical claims data. Regardless of test preference, few received CRC screening (22.3 %). Those preferring the home stool test (HST) were less likely to get tested than those preferring a colonoscopy (16.6 vs 29.9 %, χ(2) = 9.9, p = .002). Preference for HST was more strongly associated with beliefs about colonoscopy than with knowledge about colonoscopy. In the context of an RCT emphasizing colonoscopy screening for CRC, patients expressing a preference for HST are at heightened risk of remaining unscreened. Colonoscopy should be recommended as the preferred CRC test, but HSTs should be accessible and encouraged for patients who are averse to colonoscopy.Clinical trials.gov: Identifier: NCT02392143.
authors.affiliation: Department of Health and Behavior Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA. wolf@tc.columbia.edu.
authors.forename: Randi L
authors.initials: RL
authors.lastname: Wolf
authors.affiliation: Department of Health and Behavior Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Basch
authors.affiliation: Department of Health and Behavior Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Zybert
authors.affiliation: Department of Public Health, William Paterson University, Wayne, NJ, 07470, USA.
authors.forename: Corey H
authors.initials: CH
authors.lastname: Basch
authors.affiliation: 1199 SEIU Benefit and Pension Funds, New York, NY, 10036, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Ullman
authors.affiliation: 1199 SEIU Benefit and Pension Funds, New York, NY, 10036, USA.
authors.forename: Celia
authors.initials: C
authors.lastname: Shmukler
authors.affiliation: 1199 SEIU Benefit and Pension Funds, New York, NY, 10036, USA.
authors.forename: Fionnuala
authors.initials: F
authors.lastname: King
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA.|Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, 10032, USA.|Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA.
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
mesh_terms: D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008913:Minority Groups; D009519:New York City; D009780:Occult Blood; D057240:Patient Preference; D012959:Socioeconomic Factors; D014505:Urban Population
keywords: Beliefs; Colorectal cancer screening; Knowledge; Patient preferences