Correlates and Predictors of Colorectal Cancer Screening among Male Automotive Workers
- Amy McQueen1,
- Sally W. Vernon1,
- Ronald E. Myers4,
- Beatty G. Watts3,
- Eun Sul Lee2 and
- Barbara C. Tilley5
- 1Center for Health Promotion and Prevention Research and 2Department of Biometry, University of Texas School of Public Health; 3Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston, Texas; 4Division of Medical Oncology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; and 5Department of Biometery and Epidemiology, Medical University of South Carolina, Charleston, South Carolina
- Requests for reprints:
Amy McQueen, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2568, Houston, TX 77030. Phone: 713-500-9782; Fax: 713-500-9750. E-mail: Amy.McQueen{at}uth.tmc.edu
Abstract
Background: Most studies examining factors associated with colorectal cancer (CRC) screening (CRCS) are cross-sectional and thus temporal relationships cannot be determined. Furthermore, less attention has been paid to psychosocial predictors of CRCS. We examined both cross-sectional correlates of prior CRCS and predictors of prospective CRCS initiation and maintenance during The Next Step Trial, a 2-year worksite behavioral intervention to promote regular CRCS and dietary change.
Method: The sample included 2,693 White male automotive workers at increased occupational risk for, but no history of, CRC who completed a baseline survey. Stratified analyses were conducted for three dependent variables (prior CRCS, CRCS initiation, and CRCS maintenance). We also assessed prior CRCS as a moderator in prospective analyses. Multivariable logistic regression analyses with generalized linear mixed models were used to adjust for cluster sampling.
Results: Except for education, cross-sectional correlates of prior CRCS including older age, family history of CRC or polyps, personal history of polyps, self-efficacy, family support, and intention were also significant prospective predictors of increased CRCS during the trial. Despite differences in the patterns of association for CRCS initiation and maintenance in stratified analyses, the only associations with prospective CRCS that were significantly moderated by prior CRCS were family history and CRCS availability.
Conclusions: Correlates of prior CRCS that also were prospective predictors of CRCS may be suitable targets for intervention. Additionally, intervention messages addressing psychosocial constructs may be relevant for both CRCS initiation and maintenance. However, studies with more diverse samples are needed to replicate the results reported here. (Cancer Epidemiol Biomarkers Prev 2007;16(3):500–9)
- Gastrointestinal cancers: colorectal
- Cancer surveillance and screening
- Behavioral Prevention Research
- Psychosocial aspects
Footnotes
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↵6 A. McQueen, S.W. Vernon, R.E. Myers, B.C. Tilley. Examining mediators of perceived susceptibility of colorectal cancer on screening intention and behavior. Paper presented at the 27th annual meeting for Society of Behavioral Medicine, San Francisco, CA. Submitted for publication, 2006.
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Grant support: National Cancer Institute grant 5R01CA052605-04 Colorectal Cancer Screening and Nutrition Intervention; National Cancer Institute training grant R25CA57712-11 (A. McQueen); National Cancer Institute grants R01CA076330 Women Veterans and Breast Cancer Screening, R01CA097263 Tailored Interactive Intervention to Increase CRC Screening, and R03CA103512 A Cancer Study Among Female Veterans in Texas, 1979-2001 (S.W. Vernon); National Cancer Institute grants 5R01CA084140-04 Increasing Colon Cancer Screening in Primary Care, 5R21CA102418-02 Tailored Messaging in Colorectal Cancer Screening, and 5U01CA086084-05 Increasing Access to Clinical and Educational Studies (R.E. Myers); and Department of Defense grant SP0001 Occupational and Nutritional Risk Factors for Colon Cancer and Adenomatous Polyps in the Tri-Services (B.C. Tilley).
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted December 15, 2006.
- Received September 7, 2006.
- Revision received December 6, 2006.
