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Adherence to continuous screening for colorectal neoplasia
R E Myers1, A M Balshem, T A Wolf
1Population Science Division, Fox Chase Cancer Center, Philadelphia, PA 19012.
Medical Care
|June 1, 1993
Summary
Previous colorectal cancer screening strongly predicts future adherence. Special efforts are needed to improve serial and repeat screening rates, especially for younger adults and those with abnormal initial test results.
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Continuous screening offers periodic diagnostic testing for asymptomatic, at-risk populations.
- Serial screening involves periodic offers regardless of prior response, while repeat screening targets previous testers.
Purpose of the Study:
- To assess adherence to serial and repeat colorectal cancer screening in older adults.
- To identify predictors of adherence in two consecutive screening rounds.
Main Methods:
- A study involving 1,565 older adult health maintenance organization members undergoing two rounds of screening.
- Fecal occult blood tests (FOBTs) were distributed, with some participants receiving behavioral interventions in the first round.
- Logistic regression analysis was used to evaluate adherence predictors.
Main Results:
- First-round testing was a significant predictor of serial adherence across age groups (OR=10.8-10.9).
- Intervention in the first round negatively impacted serial adherence in younger subjects (OR=0.5).
- Older age predicted repeat adherence (OR=1.6), while prior intervention and abnormal results predicted lower repeat adherence (OR=0.5, OR=0.4).
Conclusions:
- Previous screening participation is a strong predictor of serial adherence.
- Targeted strategies may be necessary to enhance serial and repeat screening, particularly for younger adults.
- Further research is needed to understand low repeat screening rates among individuals with abnormal results.