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Updated: Aug 20, 2025

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Modifiable patient-reported factors associated with cancer-screening knowledge and participation in a community-based
Oluwadamilola M Fayanju1, Taofik Oyekunle2, Samantha M Thomas3
1Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA; Duke Cancer Institute, Durham, NC, 27710, USA; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA; Duke Forge, Duke University, Durham, NC, 27710, USA; Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA.
Background:
We sought to identify modifiable factors associated with cancer screening in a community-based health assessment.
Methods:
24 organizations at 47 community events in central North Carolina distributed a 91-item survey from April-December 2017. Responses about (1) interest in disease prevention, (2) lifestyle choices (e.g., diet, tobacco), and (3) perceptions of primary care access/quality were abstracted to examine their association with self-reported screening participation and knowledge about breast, prostate, and colorectal cancer.
Results:
2135/2315 participants (92%; 38.5% White, 38% Black, 9.9% Asian) completed screening questions. >70% of screen-eligible respondents reported guideline-concordant screening. Healthy dietary habits were associated with greater knowledge about breast and colorectal cancer screening; reporting negative attitudes about and barriers to healthcare were associated with less breast, prostate, and colorectal cancer screening. Having a place to seek medical care (a proxy for primary care access) was independently associated with being ∼5 times as likely to undergo colorectal screening (OR 4.66, 95% CI 1.58-13.79, all p < 0.05).
Conclusions:
In this diverse, community-based sample, modifiable factors were associated with screening engagement, highlighting opportunities for behavioral intervention.
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