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Predictors of Low Colorectal Cancer Screening in an Urban Academic Family Practice

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DOI: 10.4236/ojpm.2014.46051    3,091 Downloads   3,783 Views   Citations

ABSTRACT

Purpose: The primary objective was to describe the specific socio-demographic variables that are associated with colorectal cancer (CRC) under-screening in an urban, inner city population. The secondary objective was to determine the overall proportion of eligible patients who are not appropriately screened. Methods: A retrospective chart review of patients eligible for average-risk CRC screening as per Ontario’s ColonCancerCheck program guidelines was conducted at an academic, inner city family health practice associated with St. Michael’s Hospital in Toronto, Ontario. Simple measures of association, including t-tests and chi-square tests, were used to determine the relationships between screening and demographic characteristics. Based on a type I error rate of 0.05 and an appropriate sample size, the calculated power for this study was 0.82. Results: A total of 200 patients were randomly selected; 54% were male; the majority were non-immigrants (77.5%) and were employed or retired (76.5%). Fifty-five percent of screened patients were up to date as per guidelines; 29.5% and 31% were up to date with a fecal occult blood test or a colonoscopy respectively. Individuals with psychiatric illness (p = 0.0005), with no history of prior cancer screening for other cancers (p = 0.0001), on disability or unemployed (p = 0.0010), or who were younger (p = 0.0062) were significantly less likely to undergo CRC screening. Conclusion: Colorectal cancer screening rates at this academic, urban family practice were very similar to province wide screening rates. Future studies should focus on group specific interventions to increase CRC screening uptake in low CRC screened populations.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Culleton, S. , Slater, M. and Lofters, A. (2014) Predictors of Low Colorectal Cancer Screening in an Urban Academic Family Practice. Open Journal of Preventive Medicine, 4, 438-445. doi: 10.4236/ojpm.2014.46051.

References

[1] Canadian Cancer Society’s Steering Committee on Cancer Statistics (2013) Canadian Cancer Statistics. Canadian Cancer Society, Toronto.
[2] Wilkins, K. and Shields, M. (2009) Colorectal Cancer Testing in Canada—2008. Health Reports, 20, 21-30.
[3] Cancer Care Ontario (2012) ColonCancerCheck 2010 Program Report. Cancer Care Ontario, Toronto.
[4] Benarroch-Gampel, J., Sheffield, K.M., Lin, Y.L., Kuo, Y.F., Goodwin, J.S. and Riall, T.S. (2012) Colonoscopist and Primary Care Physician Supply and Disparities in Colorectal Cancer Screening. Health Services Research, 47, 1137-1157.
http://dx.doi.org/10.1111/j.1475-6773.2011.01355.x
[5] Dimitrakaki, C., Boulamatsis, D., Mariolis, A., Kontodimopoulos, N., Niakas, D. and Tountas, Y. (2009) Use of Cancer Screening Services in Greece and Associated Social Factors: Results from the Nation-Wide Hellas Health I Survey. European Journal of Cancer Prevention, 18, 248-257.
http://dx.doi.org/10.1097/CEJ.0b013e32832405d6
[6] Klabunde, C.N., Cronin, K.A., Breen, N., Waldron, W.R., Ambs, A.H. and Nadel, M.R. (2011) Trends in Colorectal Cancer Test Use among Vulnerable Populations in the United States. Cancer Epidemiology, Biomarkers & Prevention, 20, 1611-1621.
http://dx.doi.org/10.1158/1055-9965.EPI-11-0220
[7] Red, S.N., Kassan, E.C., Williams, R.M., Penek, S., Lynch, J., Ahaghotu, C. and Taylor, K.L. (2010) Underuse of Colorectal Cancer Screening among Men Screened for Prostate Cancer: A Teachable Moment? Cancer, 116, 4703-4710.
http://dx.doi.org/10.1002/cncr.25229
[8] von Wagner, C., Baio, G., Raine, R., Snowball, J., Morris, S., Atkin, W., Obichere, A., Handley, G., Logan, R.F., Rainbow, S., et al. (2011) Inequalities in Participation in an Organized National Colorectal Cancer Screening Programme: Results from the First 2.6 Million Invitations in England. International Journal of Epidemiology, 40, 712-718.
http://dx.doi.org/10.1093/ije/dyr008
[9] von Wagner, C., Good, A., Wright, D., Rachet, B., Obichere, A., Bloom, S. and Wardle, J. (2009) Inequalities in Colorectal Cancer Screening Participation in the First Round of the National Screening Programme in England. British Journal of Cancer, 3, S60-S63.
http://dx.doi.org/10.1038/sj.bjc.6605392
[10] White, A., Vernon, S.W., Franzini, L. and Du, X.L. (2011) Racial and Ethnic Disparities in Colorectal Cancer Screening Persisted despite Expansion of Medicare’s Screening Reimbursement. Cancer Epidemiology, Biomarkers & Prevention, 20, 811-817.
http://dx.doi.org/10.1158/1055-9965.EPI-09-0963
[11] Paddison, J.S. and Yip, M.J. (2010) Exploratory Study Examining Barriers to Participation in Colorectal Cancer Screening. The Australian Journal of Rural Health, 18, 11-15.
http://dx.doi.org/10.1111/j.1440-1584.2009.01114.x
[12] Le Retraite, L., Eisinger, F., Loundou, A., Rinaldi, Y., Seitz, J.F. and Auquier, P. (2010) Sociogeographical Factors Associated with Participation in Colorectal Cancer Screening. Gastroenterological Clinical Biology, 34, 534-540.
http://dx.doi.org/10.1016/j.gcb.2010.06.007
[13] Kodl, M.M., Powell, A.A., Noorbaloochi, S., Grill, J.P., Bangerter, A.K. and Partin, M.R. (2010) Mental Health, Frequency of Healthcare Visits, and Colorectal Cancer Screening. Medical Care, 48, 934-939.
http://dx.doi.org/10.1097/MLR.0b013e3181e57901
[14] Keating, N.L., O’Malley, A.J., Murabito, J.M., Smith, K.P. and Christakis, N.A. (2011) Minimal Social Network Effects Evident in Cancer Screening Behavior. Cancer, 117, 3045-3052.
http://dx.doi.org/10.1002/cncr.25849
[15] Sinicrope, P.S., Goode, E.L., Limburg, P.J., Vernon, S.W., Wick, J.B., Patten, C.A., Decker, P.A., Hanson, A.C., Smith, C.M., Beebe, T.J., et al. (2012) A Population-Based Study of Prevalence and Adherence Trends in Average Risk Colorectal Cancer Screening, 1997 to 2008. Cancer Epidemiology, Biomarkers & Prevention, 21, 347-350.
http://dx.doi.org/10.1158/1055-9965.EPI-11-0818
[16] Walter, L.C., Lindquist, K., Nugent, S., Schult, T., Lee, S.J., Casadei, M.A. and Partin, M.R. (2009) Impact of Age and Comorbidity on Colorectal Cancer Screening among Older Veterans. Annals of Internal Medicine, 150, 465-473.
http://dx.doi.org/10.7326/0003-4819-150-7-200904070-00006
[17] Holden, D.J., Harris, R., Porterfield, D.S., Jonas, D.E., Morgan, L.C., Reuland, D., Gilchrist, M., Viswanathan, M., Lohr, K.N. and Lyda-McDonald, B. (2010) Enhancing the Use and Quality of Colorectal Cancer Screening. Evidence Report/ Technology Assessment, 190, 1-195.
[18] Wilkins, R. (2010) PCCF+ Version 5F User’s Guide. Health Statistics Division, Statistics Canada, Ottawa, Ontario.
[19] Rosner, B. (2011) Chapter 7: Hypothesis Testing: Categorical Data/Estimation of Sample Size and Power for Comparing Two Binomial Proportions. Fundamentals of Biostatistics, 7th Edition, Brooks/Cole, Boston.
[20] Caulfield, J. (1994) Chapter 3: Reform, Deindustrialization, and the Redirection of City-Building. City Form and Everyday Life: Toronto’s Gentrification and Critical Social Practice, University of Toronto Press, Toronto, 65.
[21] Howard, L., Barley, E., Davies, E., Rigg, A., Lempp, H., Rose, D., Taylor, D. and Thornicroft, G. (2010) Cancer Diagnosis in People with Severe Mental Illness: Practical and Ethical Issues. The Lancet Oncology, 11, 797-804.
http://dx.doi.org/10.1016/S1470-2045(10)70085-1
[22] Lawrence, D. and Kisely, S. (2010) Inequalities in Healthcare Provision for People with Severe Mental Illness. Journal of Psychopharmacology, 24, 61-68.
[23] McGinty, E., Zhang, Y., Guallar, E., Ford, D., Steinwachs, D., Dixon, L., Keating, N. and Daumit, G. (2012) Cancer Incidence in a Sample of Maryland Residence with Serious Mental Illness. Psychiatric Services, 63, 714-717.
http://dx.doi.org/10.1176/appi.ps.201100169

  
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