Objective Increasing patient knowledge about the value of colorectal cancer (CRC) screening is a goal of most public health education efforts. We hypothesized that a cohort of women at average risk for CRC, but non-compliant with standard screening recommendations, would demonstrate low levels of CRC related knowledge and underestimate their personal risk for developing CRC. Methods Baseline survey results are reported from a prospective trial designed to improve CRC screening participation in women at average risk, but non-complaint with screening recommendations. Women scheduled for a routine gynecological office visit were identified and contacted by telephone approximately 4 weeks before their index appointment. All participants completed a 75 item baseline survey that included items assessing demographic information, CRC knowledge, risk perception and intention to participate in screening. Results Women (n=318) enrolled from June, 2006-May, 2007 are included. Participants demonstrated high levels of CRC and CRC screening related knowledge answering an average of 8.6/10 items correctly (SD 1.30). The majority of these non-compliant women (1) estimated their CRC risk incorrectly (60%) and (2) had no intention of CRC screening participation in the future (65%). Multivariate models found no consistent relationships between knowledge, risk perception, and screening intent. Conclusions Greater “knowledge” alone is an inadequate stimulus to CRC screening adherence. Future interventions will require a greater understanding of the interplay between CRC-related knowledge, beliefs, risk perception, and other affective responses.

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