Colorectal cancer information avoidance is associated with screening adherence

Area of Science:

• Oncology
• Health Behavior
• Public Health

Background:

• Colorectal cancer (CRC) is a leading cause of cancer death in the U.S.
• CRC screening adherence is suboptimal, with less than two-thirds of U.S. adults following guidelines.
• Understanding barriers to CRC screening is crucial for improving early detection and prevention.

Purpose of the Study:

• To investigate if defensive avoidance of CRC information is associated with lower screening adherence and intentions.
• To determine if CRC information avoidance predicts screening behavior beyond established determinants.
• To identify potential strategies for engaging individuals who avoid CRC information.

Main Methods:

• Survey of 887 adults (aged 45-75) assessing CRC screening behavior, intentions, and information avoidance tendencies.
• Inclusion of known structural determinants of screening: healthcare coverage, utilization, and provider recommendation.
• Analysis using multivariable regression and structural equation modeling (SEM) to assess relationships.

Main Results:

• Higher CRC information avoidance was significantly linked to lower odds of screening adherence (OR=0.55).
• Among non-adherent individuals, greater avoidance predicted weaker intentions to be screened (b=-0.50).
• Information avoidance negatively correlated with structural determinants and screening adherence in SEM models, improving model fit when included.

Conclusions:

• Defensive avoidance of CRC information is a significant barrier to screening adherence and intention.
• Information avoidance independently predicts screening behavior and interacts with known structural factors.
• Novel health communication and external interventions are needed to reach and engage CRC information avoiders.