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Aim: International studies have shown that most colon cancers are diagnosed among people with symptoms, but research is limited in the United States. Here, we conducted a retrospective study of adults aged 50–85 years diagnosed with stage I–IIIA colon cancer between 1995 and 2014 in two US healthcare systems. Methods: Mode of detection (screening or symptomatic) was ascertained from medical records. We estimated unadjusted odds ratios (OR) and 95% confidence intervals (CI) comparing detection mode by patient factors at diagnosis (year, age, sex, race, smoking status, body mass index [BMI], Charlson score), prediagnostic primary care utilization, and tumour characteristics (stage, location). Results: Of 1,675 people with colon cancer, 38.4% were screen‐detected, while 61.6% were diagnosed following symptomatic presentation. Screen‐detected cancer was more common among those diagnosed between 2010 and 2014 versus 1995–1999 (OR 1.65, 95% CI: 1.19–2.28), and those with a BMI of 25–<30 kg/m2 (OR 1.54, 95% CI: 1.21–1.98) or ≥30 kg/m2 (OR 1.52, 95% CI: 1.18–1.96) versus <25 kg/m2. Screen‐detected cancer was less common among people aged 76–85 (OR 0.50, 95% CI: 0.39–0.65) versus 50–64, those with comorbidity scores >0 (OR 0.71, 95% CI: 0.56–0.91 for score = 1, OR 0.34, 95% CI: 0.26–0.45 for score = 2+), and those with 2+ prediagnostic primary care visits (OR 0.53, 95% CI: 0.37–0.76) versus 0 visits. The odds of screen detection were lower among patients diagnosed with stage IIA (OR 0.33, 95% CI = 0.27–0.41) or IIB (OR 0.12, 95% CI: 0.06–0.24) cancers versus stage I. Conclusions: Most colon cancers among screen‐eligible adults were diagnosed following symptomatic presentation. Even with increasing screening rates over time, research is needed to better understand why specific groups are more likely to be diagnosed when symptomatic and identify opportunities for interventions. [ABSTRACT FROM AUTHOR]

Objective: Socioeconomic gaps in cancer mortality may be driven partially by poorer uptake of early detection behaviors among lower socioeconomic status (SES) groups. Lower SES groups may hold both fewer positive and more negative cancer beliefs that discourage these behaviors. We examined SES differences in positive and negative cancer beliefs in US adults. Methods: We conducted telephone interviews with a population‐representative sample, aged 50+, using the Awareness and Beliefs about Cancer instrument (N = 1425). Cancer beliefs were measured using three positively and three negatively framed items. We used multivariable logistic regression models to examine associations between beliefs and education, which served as a marker of individual‐level SES. Results: Agreement with positive statements was high (>80%) and did not vary with education, while agreement with negative statements varied. Relative to adults with a bachelor's degree, adults with a high school degree or less were more likely to agree that "treatment is worse than cancer" (45.2% vs. 68.2%; adjusted odds ratio (aOR) = 2.43, 99% CI = 1.50–3.94), cancer is "a death sentence" (17.4% vs. 33.2%; aOR = 2.51, 99% CI = 1.45–4.37), and they "would not want to know if I have cancer" (15.7% vs. 31.6%; aOR = 2.88, 99% CI = 1.54–5.36). Conclusions: Positive cancer statements were generally endorsed, but negative statements were more frequently endorsed by lower SES groups. Additional work is needed to understand how negative beliefs develop and coexist alongside positive beliefs. Interventions to improve detection behaviors targeting lower SES groups may benefit from focusing on reducing negative beliefs, rather than increasing positive beliefs. [ABSTRACT FROM AUTHOR]

Background: Although larger social networks have been associated with lower all-cause mortality, few studies have examined whether social integration predicts survival outcomes among patients with colorectal cancer (CRC). The authors examined the association between social ties and survival after CRC diagnosis in a prospective cohort study.Methods: Participants included 896 women in the Nurses' Health Study who were diagnosed with stage I, II, or III CRC between 1992 and 2012. Stage was assigned using the American Joint Committee on Cancer criteria. Social integration was assessed every 4 years since 1992 using the Berkman-Syme Social Network Index, which included marital status, social network size, contact frequency, religious participation, and other social group participation.Results: During follow-up, there were 380 total deaths, 167 of which were due to CRC. In multivariable analyses, women who were socially integrated before diagnosis had a subsequent reduced risk of all-cause mortality (hazard ratio [HR], 0.65; 95% confidence interval [95% CI], 0.46-0.92) and CRC mortality (HR, 0.63; 95% CI, 0.38-1.06) compared with women who were socially isolated. In particular, women with more intimate ties (family and friends) had lower all-cause mortality (HR, 0.61; 95% CI, 0.42-0.88) and CRC mortality (HR, 0.59; 95% CI, 0.34-1.03) compared with those with few intimate ties. Participation in religious or community activities was not found to be related to outcomes. The analysis of postdiagnosis social integration yielded similar results.Conclusions: Socially integrated women were found to have better survival after a diagnosis of CRC, possibly due to beneficial caregiving from their family and friends. Interventions aimed at strengthening social network structures to ensure access to care may be valuable programmatic tools in the management of patients with CRC. Cancer 2018;124:833-40. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]