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PROMOTING COLORECTAL CANCER SCREENING AMONG THOSE WHO HAVE NEVER BEEN SCREENED

R Walker, SE McGregor, RJ Hilsden, G Currie, SJ Heitman, AM Irving, J Bergman, D Sadowski
Alberta Cancer Board; University of Alberta, Edmonton; University of Calgary, Calgary, Alberta

OBJECTIVE: To identify factors that may be important in promoting colorectal cancer (CRC) screening among those who have never been screened.
METHODS: In depth, in-person interviews were completed on 218 people in the general population aged 50-74 in Alberta. Information was collected on prior screening experiences, health care practices and potential factors influencing screening practices. Most participants had never been screened for CRC (n=121, 56%), 26% (n=56) had been screened, and 18% (n=40) had investigational procedures. This analysis is restricted to those who have never been screened.
RESULTS: 55% of patients were males; 51% of patients were aged 50-59. 86% (n=104) reported going to their family physician for a regular routine check-up and 85% (n=103) reported that their family physician is their preferred source for health information. When making decisions about which tests to have, 36% prefer to share the decision with their physician and 28% prefer the physician makes the final decision. However, 72% (n=87) of participants had never discussed CRC with their physician even though 67% (n=78) report that CRC is a serious concern for them and 83% (n=98) believe that CRC screening is important for them. 85% perceive their risk of CRC to be the same or lower than other people their own age. In regard to CRC screening in the next year, the majority of participants (n=75) plan to discuss it with their family physician. The table below describes some of the factors that may influence CRC screening practices.

I would be more likely to be screened if: Agree Uncertain Disagree
I had symptoms 98.4% - 1.6%
My doctor recommended the test 94.2% 4.1% 1.7%
It was included as a regular routine check-up 87.6% 5.0% 7.4%
I understood how likely I was to develop CRC 94.2% 5.8% -
My family member was diagnosed with CR C 96.7% 1.6% 1.7%

CONCLUSIONS: Most participants recognized that CRC is a serious a concern yet had not been screened. It appears that family physicians may play an important role in promoting CRC screening, not only by recommending screening but by educating patients about the concept of screening in the absence of symptoms and CRC risk. Having screening tests included in regular routine medical check-ups may also promote screening adherence.

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I would be more likely to be screened if:	Agree	Uncertain	Disagree
I had symptoms	98.4%	-	1.6%
My doctor recommended the test	94.2%	4.1%	1.7%
It was included as a regular routine check-up	87.6%	5.0%	7.4%
I understood how likely I was to develop CRC	94.2%	5.8%	-
My family member was diagnosed with CR C	96.7%	1.6%	1.7%