Underuse of colorectal cancer screening among men screened for prostate cancer

Red, Sara N.; Kassan, Elisabeth C.; Williams, Randi M.; Penek, Sofiya; Lynch, John H.; Ahaghotu, Chiledum; Taylor, Kathryn L.

doi:10.1002/cncr.25229

Cited by 8 publications

(6 citation statements)

References 96 publications

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“…A similar association was found by this group with mammography18 and in an analysis of updated data by Wong and Coups 15. Our data are most readily compared with those recently published by Red et al24 In their multivariate analysis of 331 adult men (60% African American) undergoing free prostate cancer screening through a clinic at Georgetown Medical Center, these investigators did not find race to be predictive of CRC screening compliance, but, similar to the analyses of the BRFSS by Carlos et al, found prostate cancer screening, health insurance, and having a regular primary care provider to be predictive of both ever having had and adherence to colorectal cancer screening. Of note, although similar in racial composition to our cohort, the participants in the Georgetown study are different from those examined in our research, as our population enrolls in the Prostate Cancer Risk Assessment Program for education, clinical surveillance, and research participation relative to prostate cancer risk assessment.…”

Section: Discussionsupporting

confidence: 90%

Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

Hall¹,

Ruth²,

Giri³

2011

Cancer

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Background Screening by fecal occult blood test and lower endoscopy have lowered colorectal cancer (CRC) mortality, but compliance gaps persist. Of concern are possible disparities in uptake of CRC screening between White and African American (AA) men. Our goal was to assess for disparities in uptake of CRC screening among men participating in a high-risk prostate cancer clinic. If present, such disparities could support hypotheses for further research examining racial differences in awareness and patient preferences in undergoing CRC screening. Methods Baseline data on a racially diverse cohort of men age 50–69 at increased risk of prostate cancer collected via the prostate cancer risk assessment program (PRAP) at Fox Chase Cancer Center were analyzed. Predictors of uptake of CRC screening were assessed using multivariable logistic regression. Results Compared to Whites, AA men had statistically significantly lower uptake of fecal occult blood testing (AA 49.0% vs White 60.7%, p=0.035), lower endoscopy (AA 44.1% vs White 58.5%, p=0.011), and any CRC screening (AA 66.2% vs White 76.3%, p=0.053). Predictors of uptake of lower endoscopy among AA men included older age (OR 3.61, 95% CI 1.87–6.97), family history of CRC (OR 3.47, 95% CI 1.30–9.25), and insurance status (OR 1.90, 95% CI 1.04–3.46). Conclusion Despite awareness of cancer risk and motivation to seek prostate cancer screening through a specialized prostate cancer risk assessment program, evidence supporting compliance gaps with CRC screening among men was found. Tailored messages to younger AA men with and without a family history of CRC are needed.

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Section: Discussionsupporting

confidence: 90%

Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

Hall¹,

Ruth²,

Giri³

2011

Cancer

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“…Similar results have been reported with patients 65 years and under significantly less likely to undergo CRC screening [2] [3]. The association between no prior history of other cancer screening and low CRC screening has been reported in prior literature [7] [15]. One study reported that individuals who attributed embarrassment and discomfort to breast or prostate cancer screening were significantly less likely to undergo CRC screening [11].…”

Section: Discussionsupporting

confidence: 81%

“…smoking, obesity, etc.) [2] [7] [13]- [16]. Of all these factors, SES is a particularly important social determinant, accounting for up to 62% in the variance of CRC screening participation rates [9].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Low Colorectal Cancer Screening in an Urban Academic Family Practice

Culleton¹,

Slater²,

Lofters³

2014

OJPM

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Purpose: The primary objective was to describe the specific socio-demographic variables that are associated with colorectal cancer (CRC) under-screening in an urban, inner city population. The secondary objective was to determine the overall proportion of eligible patients who are not appropriately screened. Methods: A retrospective chart review of patients eligible for average-risk CRC screening as per Ontario's ColonCancerCheck program guidelines was conducted at an academic, inner city family health practice associated with St. Michael's Hospital in Toronto, Ontario. Simple measures of association, including t-tests and chi-square tests, were used to determine the relationships between screening and demographic characteristics. Based on a type I error rate of 0.05 and an appropriate sample size, the calculated power for this study was 0.82. Results: A total of 200 patients were randomly selected; 54% were male; the majority were non-immigrants (77.5%) and were employed or retired (76.5%). Fifty-five percent of screened patients were up to date as per guidelines; 29.5% and 31% were up to date with a fecal occult blood test or a colonoscopy respectively. Individuals with psychiatric illness (p = 0.0005), with no history of prior cancer screening for other cancers (p = 0.0001), on disability or unemployed (p = 0.0010), or who were younger (p = 0.0062) were significantly less likely to undergo CRC screening. Conclusion: Colorectal cancer screening rates at this academic, urban family practice were very similar to province wide screening rates. Future studies should focus on group specific interventions to increase CRC screening uptake in low CRC screened populations.

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“…The populations perceived by health service providers and community members to have low cancer screening participation in Ontario were similar to other studies and included: the uninsured [ 11 , 18 , 20 ], sexual abuse survivors [ 42 - 47 ], people living in crisis, immigrants [ 11 - 17 ], and men [ 5 ]. There was substantial screening heterogeneity within each of these groups, from never-screened to under-screened for all eligible cancers; to up-to-date on some cancer screens but not all eligible screens; to fully screened for all eligible cancers.…”

Section: Discussionmentioning

confidence: 99%

Who are the under- and never- screened for cancer in Ontario: a qualitative investigation

et al. 2014

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BackgroundObserved breast, cervical and colon cancer screening rates are below provincial targets for the province of Ontario, Canada. The populations who are under- or never-screened for these cancers have not been described at the Ontario provincial level. Our objective was to use qualitative methods of inquiry to explore who are the never- or under-screened populations of Ontario.MethodsQualitative data were collected from two rounds of focus group discussions conducted in four communities selected using maps of screening rates by dissemination area. The communities selected were archetypical of the Ontario context: urban, suburban, small city and rural. The first phase of focus groups was with health service providers. The second phase of focus groups was with community members from the under- and never- screened population. Guided by a grounded theory methodology, data were collected and analyzed simultaneously to enable the core and related concepts about the under- and never-screened to emerge.ResultsThe core concept that emerged from the data is that the under- and never-screened populations of Ontario are characterized by diversity. Group level characteristics of the under- and never- screened included: 1) the uninsured (e.g., Old Order Mennonites and illegal immigrants); 2) sexual abuse survivors; 3) people in crisis; 4) immigrants; 5) men; and 6) individuals accessing traditional, alternative and complementary medicine for health and wellness. Under- and never-screened could have one or multiple group characteristics.ConclusionThe under- and never-screened in Ontario comprise a diversity of groups. Heterogeneity within and intersectionality among under- and never-screened groups adds complexity to cancer screening participation and program planning.

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Underuse of colorectal cancer screening among men screened for prostate cancer

Cited by 8 publications

References 96 publications

Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

Rates and predictors of colorectal cancer screening by race among motivated men participating in a prostate cancer risk assessment program

Predictors of Low Colorectal Cancer Screening in an Urban Academic Family Practice

Who are the under- and never- screened for cancer in Ontario: a qualitative investigation

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