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194 CORRELATES OF ADHERENCE TO COLORECTAL CANCER SCREENING GUIDELINES IN FOUR CANADIAN PROVINCES MJ Sewitch, C Fournier, A Ciampi, A Dyanchenko PURPOSE: This population-based study used a biopsychosocial framework to identify correlates of adherence to colorectal cancer (CRC) screening guidelines in average-risk residents of Newfoundland, Ontario, Saskatchewan and British Columbia.
METHODS: The study sample included respondents to the 2003 Canadian Community Health Survey Cycle 2.1 who were 50 years of age and older and without past or present CRC. Three adherence outcomes were defined: i) having an FOBT in the past 2 years, ii) having a screening endoscopy (colonoscopy/flexible sigmoidoscopy) in the past 10 years, and iii) adhering to CRC screening guidelines, defined as either (i) or (ii). Discriminant analysis using generalized estimating equations was employed to identify socio-demographic, lifestyle, clinical, psychosocial and environmental correlates of the three adherence outcomes.
RESULT: Of the 17,646 respondents (representing 2,529,577 Canadians), 70% were non-adherent to CRC screening guidelines. Specifically, 85% and 79% were non-adherent to FOBT and endoscopy screening, respectively. Correlates for all outcomes were: having a regular physician (OR= (i) 2.67; (ii) 1.90; (iii) 2.38), getting a flu shot (OR= (i) 1.59; (ii) 1.50; (iii) 1.56), and having a chronic condition (OR= (i) 1.32; (ii) 1.48; (iii) 1.43). Participation in physical activity, increased consumption of fruits and vegetables and smoking cessation were each associated with at least 1 outcome. Across provinces, self-perceived stress was the only psychosocial characteristic associated with increased odds of endoscopy screening and adherence to CRC screening guidelines (OR= (ii) 1.07; (iii) 1.06).
CONCLUSION: Respondents having a regular physician, a chronic condition, or are stressed may seek frequent health care, which may increase their chances of receiving preventive health services. Healthy lifestyle behaviours were associated with adherence to CRC screening.