Understanding Cancer Worry Among Patients in a Community Clinic-Based Colorectal Cancer Screening Intervention Study

Shannon M Christy; Alyssa Schmidt; Hsiao-Lan Wang; Steven K Sutton; Stacy N Davis; Enmanuel Chavarria; Rania Abdulla; Gwendolyn P Quinn; Susan T Vadaparampil; Ida Schultz; Richard Roetzheim; David Shibata; Cathy D Meade; Clement K Gwede

doi:10.1097/NNR.0000000000000275

Understanding Cancer Worry Among Patients in a Community Clinic-Based Colorectal Cancer Screening Intervention Study

Nurs Res. 2018 Jul/Aug;67(4):275-285. doi: 10.1097/NNR.0000000000000275.

Authors

Shannon M Christy¹, Alyssa Schmidt, Hsiao-Lan Wang, Steven K Sutton, Stacy N Davis, Enmanuel Chavarria, Rania Abdulla, Gwendolyn P Quinn, Susan T Vadaparampil, Ida Schultz, Richard Roetzheim, David Shibata, Cathy D Meade, Clement K Gwede

Affiliation

¹ Shannon M. Christy, PhD, is Assistant Professor, Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis. At the time this manuscript was prepared and submitted, Dr. Christy was a Postdoctoral Fellow, Division of Population Science, Moffitt Cancer Center, and Postdoctoral Fellow, Morsani College of Medicine, University of South Florida, Tampa, Florida. Alyssa Schmidt, MPH, PA-C, is Physician Assistant at WVP Boulder Creek Family Medicine, Salem, Oregon. At the time the research was conducted, she was a Research Coordinator, Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Hsiao-Lan Wang, PhD, RN, CMSRN, ACSM EP-C, is Associate Professor, College of Nursing, University of South Florida, Tampa, Florida. Steven K. Sutton, PhD, is Assistant Member, Division of Quantitative Science, Moffitt Cancer Center, and Assistant Professor, Morsani College of Medicine, University of South Florida, Tampa, Florida. Stacy N. Davis, PhD, MPH, is Instructor, Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, New Jersey. At the time the research was conducted, Dr. Davis was a Postdoctoral Fellow, Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Enmanuel Chavarria, PhD, CHES, is Assistant Professor, University of Texas Health Science Center at Houston School of Public Health, Brownsville. At the time the research was conducted, Dr. Chavarria was a Postdoctoral Fellow, Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Rania Abdulla, MA, is Research Program Administrator, Division of Population Science, Moffitt Cancer Center, Tampa, Florida. Gwendolyn P. Quinn, PhD, is Liva Wan Endowed Chair and Vice-Chair of Research, and Professor, Department of Ob-Gyn, New York University School of Medicine, New York. At the time the research was conducted, Dr. Quinn was a Senior Member, Division of Population Science, Moffitt Cancer Center, and Professor, Morsani College of Medicine, University of South Florida, Tampa, Florida. Susan T. Vadaparampil, PhD, MPH, is Senior Member, Division of Population Science, Moffitt Cancer Center, and Professor, Morsani College of Medicine, University of South Florida, Tampa, Florida. Ida Schultz, LPN, is Office Manager, Premier Community HealthCare Group, Inc., Dade City, Florida. Richard Roetzheim, MD, MSPH, is Physician, Division of Population Science, Moffitt Cancer Center, and Professor and Chair, Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida. David Shibata, MD, FACS, FASCRS, is Scheinberg Endowed Chair in Surgery and Professor, Surgeon-in-Chief, and Chair of the Department of Surgery, University of Tennessee Health Science Center, and Deputy Director, University of Tennessee West Cancer Center, Memphis. At the time this research was conducted, Dr. Shibata was Senior Member and Chief of the Section of Colorectal Oncology, Moffitt Cancer Center, and Professor of Surgery and Oncology, Morsani College of Medicine, University of South Florida, Tampa, Florida. Cathy D. Meade, PhD, RN, FAAN, is Senior Member, Division of Population Science, Moffitt Cancer Center, and Professor, Morsani College of Medicine, University of South Florida, Tampa, Florida. Clement K. Gwede, PhD, MPH, RN, FAAN, is Senior Member, Division of Population Science, Moffitt Cancer Center, and Professor, Morsani College of Medicine, University of South Florida, Tampa, Florida.

Abstract

Background: To reduce colorectal cancer (CRC) screening disparities, it is important to understand correlates of different types of cancer worry among ethnically diverse individuals.

Objectives: The current study examined the prevalence of three types of cancer worry (i.e., general cancer worry, CRC-specific worry, and worry about CRC test results) as well as sociodemographic and health-related predictors for each type of cancer worry.

Methods: Participants were aged 50-75, at average CRC risk, nonadherent to CRC screening guidelines, and enrolled in a randomized controlled trial to increase CRC screening. Participants completed a baseline questionnaire assessing sociodemographics, health beliefs, healthcare experiences, and three cancer worry measures. Associations between study variables were examined with separate univariate and multivariable logistic regression models.

Results: Responses from a total of 416 participants were used. Of these, 47% reported experiencing moderate-to-high levels of general cancer worry. Predictors of general cancer worry were salience and coherence (aOR = 1.1, 95% CI [1.0, 1.3]), perceived susceptibility (aOR = 1.2, 95% CI [1.1, 1.3), and social influence (aOR = 1.1, 95% CI [1.0, 0.1]). Fewer (23%) reported moderate-to-high levels of CRC-specific worry or CRC test worry (35%). Predictors of CRC worry were perceived susceptibility (aOR = 1.4, 95% CI [1.3, 1.6]) and social influence (aOR = 1.1, 95% CI [1.0, 1.2]); predictors of CRC test result worry were perceived susceptibility (aOR = 1.2, 95% CI [1.1, 1.3) and marital status (aOR = 2.0, 95% CI [1.1, 3.7] for married/partnered vs. single and aOR = 2.3, 95% CI [1.3, 4.1] for divorced/widowed vs. single).

Discussion: Perceived susceptibility consistently predicted the three types of cancer worry, whereas other predictors varied between cancer worry types and in magnitude of association. The three types of cancer worry were generally predicted by health beliefs, suggesting potential malleability. Future research should include multiple measures of cancer worry and clear definitions of how cancer worry is measured.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anxiety / etiology
Anxiety / psychology*
Colorectal Neoplasms / complications
Colorectal Neoplasms / diagnosis*
Colorectal Neoplasms / psychology
Early Detection of Cancer / methods
Early Detection of Cancer / standards
Early Detection of Cancer / statistics & numerical data
Female
Florida
Humans
Logistic Models
Male
Mass Screening / psychology*
Mass Screening / standards
Mass Screening / statistics & numerical data
Middle Aged
Psychometrics / instrumentation
Psychometrics / methods
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding