However, publication of evidence supporting CRC screening for average-risk adults over 50 years of age and the release of guidelines recommending screening may neither result in a significant change in physicians’ practices, nor in the screening behaviours of the public. American guidelines recommending CRC screening were introduced in the middle 1990s. However, since then, self-reported screening rates for CRC have changed very little and lag behind other recommended cancer screening tests.
Predictors of colorectal cancer's archives
The importance of factors which may trigger a physician visit (eg, screening for other cancers, having a chronic condition) in predicting screening for CRC in the cohort suggests that screening, at least in cohort members, is restricted to those already regularly accessing care. Public education programs and interventions to specifically invite average-risk adults for screening, in addition to strategies involving family physicians, are required to increase CRC screening rates.
Men who had at least one chronic condition were more likely to be recently screened. Examination of the data found that there was not any specific condition associated with being screened. The most common conditions reported by average-risk men were high cholesterol (38%) and high blood pressure (33%). We speculate that in the absence of long-standing and available screening for other types of cancers, other triggers such as regular monitoring for high blood pressure are required for men to initiate a physician visit, increasing the likelihood of the discussion of CRC screening and testing.
Living in a metropolitan RHA compared with a nonmetropolitan area was associated with higher screening rates in men; a finding which has also been observed in prostate cancer screening and perhaps reflects the higher profile of screening in specialists who tend to be concentrated in urban areas. The high correlation between PSA testing and CRC screening may be partly due to digital rectal examination, which is recommended for men who choose to have prostate cancer screening and which may also be used by some physicians to screen for rectal cancer.
There are a number of differences in methodology in the Ontario study that make it difficult to compare these findings directly with those of the present study. Income was not measured directly in the Ontario study (mean household income of residential enumeration area was used as a surrogate for personal income); no information on educational attainment was available; and the outcomes were assessed differently. It is possible that educational attainment, another measure of SES, is more useful in explaining CRC screening behaviour;
Higher rates in the United States may reflect the earlier publication of recommendations for screening, differences in clinical recommendations and accompanying American public education programs. In American studies, men tend to report higher rates of sigmoidoscopy compared with women. The lack of differences in CRC screening practices between men and women in the present study may simply reflect the very low use of these tests in cohort members.
Women who were active screeners for breast and cervical cancer were more likely to have had an FOB test for screening in the previous two years compared with women who were not up-to-date on these screening tests (Table 4). Education, age and employment status were also predictors in women but geographical region was not. Income was not a predictor of recent FOB test screening for either men or women. Screening in people at average-risk for CRC was infrequent in cohort members and lagged behind screening for other types of cancers.
To focus on subjects with no specific triggers for colorectal testing, the present analysis was restricted to the 4173 subjects who reported no risk factors for CRC. The analysis was further restricted to an examination of FOB testing practices because of the low frequency of endoscopy for routine screening. In men, the strongest predictors of having a screening FOB test within the previous two years were having had a PSA test within the previous year and educational attainment (Table 3).
Subjects at elevated or high risk were more likely to have had a recent endoscopy than a recent FOB test and over 80% of high-risk subjects had been tested within the previous five years. Recent endoscopy testing, particularly for screening, was infrequent in those at average risk, with only 1.9% (95% CI 1.6% to 2.4%) of subjects reporting an endoscopy for routine reasons within the previous five years. Investigation of a problem or symptoms (76.1% men; 86.4% women) was the most commonly reported reason for a recent endoscopy in average-risk subjects.
First-degree family history in at least one relative was the most common risk factor for CRC (10.4%), followed by a personal history of colorectal polyps (6.6%). Few subjects reported a personal history of Crohn’s disease and/or ulcerative colitis (1.7%). The prevalence of risk factors increased with age, with 14.3% and 20.8% of subjects aged 50 to 59 years and 60 to 69 years, respectively, reporting at least one risk factor for CRC. The majority of subjects (83.3%) reported no risk factors for CRC and were considered to be at average risk.
More About The Site
- Accepted treatments
- Antibiotic Treatment
- Antimycobacterial Antibody Levels
- Bacterial peritonitis
- Bromocriptine Treatment
- Bronchioloalveolar Cell Carcinoma
- Canadian Health&Care Mall
- Canadian Neighbor Pharmacy
- Cardiac function
- Cardiovascular Effects
- Chemical Denervation
- Chronic hepatitis C
- Cystic Fibrosis
- Erectile dysfunction
- Erectile Dysfunction Treatment
- Gastrointestinal and pancreatic fistulas
- Health Care
- Heart Disease
- Hemophilus Influenzae
- Hepatic regeneration
- Hepatitis B virus
- Hepatorenal syndrome
- Home Care
- Inflammatory bowel disease
- Intestinal lymphangiectasia
- Intrathoracic Lymphadenopathy
- Lamivudine for the treatment
- Licensing of a drug
- Lung Cancer
- Lung Opacities
- Lung Parenchyma
- Mechanical Ventilation
- Mens Health
- My Canadian Pharmacy
- Myocardial Infarction
- Obstructive Sleep Apnea
- Predictors of colorectal cancer
- Pulmonary Alveolar Proteinosis
- Pulmonary function
- Pulmonary Hypertension
- Pulmonary Imaging
- Pulse Oximetry
- Respiratory Disease
- Sleep Apnea
- Thoracic Surgery
- Tracheoesophageal Fistula Formation
- ATP, Basolateral membrane transport, Bile, Bile flow, Bile salt, Canalicular transport, cardiac output, CdK, chemoprophylaxis, Cholestasis, Cholesterol gallstones, CT, Cyclin, depression, digital imaging, dyspnea, erythromycin, GABA, Hepatitis B virus, HGF, hiv infection, IL-6, imaging, legionella pneumonia, legionellosis, legionnaires disease, Liver, Liver disease, Liver regeneration, lung, lung cancer, MDR3 deficiency, MRI, Multidrug resistance protein, Oxidative stress, oxygen consumption, patient aids, positron emission tomgraphy, Progressive familial intrahepatic cholestasis, pulmonary, respiratory, sleep apnea, TGF-fi, TNF, Tuberculosis