Psychosocial and medical predictors of colorectal cancer screening among low-income medical outpatients

J Cancer Educ. Fall 2004;19(3):180-6. doi: 10.1207/s15430154jce1903_14.


Background: Identification of factors related to colorectal cancer screening (CRC) and intent to obtain fecal occult blood tests (FOBTs) among low-income persons are important because CRC incidence and mortality are higher among socioeconomically disadvantaged populations.

Method: Participants were 193 individuals 50 years of age and older. CRC screening and intent to obtain FOBTs were dependent measures. Demographic variables, objective risk factors, and health beliefs were independent measures.

Results: Digital rectal examinations and FOBTs were obtained by 41% and 22%, respectively, during the previous year. Flexible sigmoidoscopies were obtained by only 19% of those 55 years of age and older during the previous five years. Multivariate analyses showed that family history of CRC, personal history of polyps, and physician recommendation were the strongest predictors of CRC screening. Family history of CRC and self-efficacy were related to intent to obtain FOBTs.

Conclusions: Results suggest the importance of physician assessment of personal and family CRC risk factors, as well as recommendation of CRC screening, to all patients as part of routine medical care.

MeSH terms

  • Aged
  • Attitude to Health*
  • Colonoscopy
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / psychology*
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Occult Blood*
  • Outpatients / psychology
  • Patient Compliance / psychology
  • Physical Examination / methods
  • Physician-Patient Relations
  • Poverty / psychology
  • Psychology
  • Risk Factors