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Behavioral associations between prostate and colon cancer screening
Ruth C Carlos1, Willie Underwood, A Mark Fendrick
1Department of Radiology, University of Michigan, Ann Arbor, MI 48109-0030, USA.
Journal of the American College of Surgeons
|January 25, 2005
Summary
Men are more likely to undergo prostate-specific antigen (PSA) screening than colorectal cancer (CRC) screening. However, PSA screening can serve as a teachable moment to increase CRC screening adherence.
Area of Science:
- Oncology
- Public Health
- Preventive Medicine
Background:
- Prostate-specific antigen (PSA) screening is widespread despite controversy.
- Colorectal cancer (CRC) screening reduces mortality but has suboptimal adherence.
- Understanding screening behaviors can improve CRC screening rates.
Purpose of the Study:
- To identify factors associated with colorectal cancer (CRC) screening adherence in men.
- To explore the relationship between prostate-specific antigen (PSA) testing and CRC screening behavior.
Main Methods:
- Analysis of 22,304 men aged 50+ from the 2002 Behavioral Risk Factors Surveillance Survey.
- Chi-square and multivariate analyses to determine correlates of CRC screening adherence.
- Evaluation of variables including age, race, socioeconomic status, health insurance, physician access, general health, smoking, and PSA testing.
Main Results:
- Men were more adherent to PSA screening (50.4%) than CRC screening (47.6%).
- PSA screening adherence was the strongest independent predictor of CRC screening adherence (OR 3.24).
- Health insurance, personal physician access, and age were also associated with CRC screening adherence, while good self-reported health and smoking were negatively associated.
Conclusions:
- PSA testing is more common than CRC screening among men.
- Men who received PSA testing were significantly more likely to adhere to CRC screening.
- PSA screening presents a "teachable moment" to promote CRC screening interventions and reduce colon cancer risk.