title: Differences between husbands and wives in colonoscopy use: Results from a national sample of married couples.
abstract: Marriage is linked to improved colorectal cancer-related health, likely in part through preventive health behaviors, but it is unclear what role spouses play in colorectal cancer screening. We therefore determine whether self-reported colonoscopy rates are correlated within married couples and the characteristics of spouses associated with colonoscopy use in each partner. We use US nationally-representative 2010 data which includes 804 male-female married couples drawn from a total sample of 3137 community-dwelling adults aged 55-90years old. Using a logistic regression model in the full sample (N=3137), we first find married men have higher adjusted colonoscopy rates than unmarried men (61% versus 52%, p=0.023), but women's rates do not differ by marital status. In the couples' sample (N=804 couples), we use a bivariate probit regression model to estimate multiple regression equations for the two spouses simultaneously as a function of individual and spousal covariates, as well as the adjusted correlation within couples. We find that individuals are nearly twice as likely to receive a colonoscopy if their spouse recently has had one (OR=1.94, 95% CI: 1.39, 2.67, p<0.001). Additionally, we find that husbands have higher adjusted colonoscopy rates whose wives are: 1) happier with the marital relationship (65% vs 51%, p=0.020); 2) more highly educated (72% vs 51%, p=0.020), and 3) viewed as more supportive (65% vs 52%, p=0.020). Recognizing the role of marital status, relationship quality, and spousal characteristics on colonoscopy uptake, particularly in men, could help physicians increase guideline adherence.
authors.affiliation: Brigham and Women's Hospital, Department of Medicine, 75 Francis St, Boston, MA 02115, USA.
authors.forename: Ashwin A
authors.initials: AA
authors.lastname: Kotwal
authors.affiliation: University of Chicago, Department of Public Health Sciences, 5841 S. Maryland Ave, Chicago, IL 60637, USA.
authors.forename: Diane S
authors.initials: DS
authors.lastname: Lauderdale
authors.affiliation: University of Chicago, Department of Sociology, 1159 E. 59(th) Street, Chicago, IL 60637, USA.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Waite
authors.affiliation: University of Chicago, Department of Medicine, Section of Geriatrics & Palliative Medicine and Hematology/Oncology, 5841 S. Maryland Ave, Chicago, IL 60637, USA. Electronic address: wdale@medicine.bsd.uchicago.edu.
authors.forename: William
authors.initials: W
authors.lastname: Dale
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000379:methods; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data*; D018454:Spouses / Q000706:statistics & numerical data*; D014481:United States
keywords: Cancer screening; Colonoscopy; Colorectal cancer; Marriage; Social networks