Predictors of Colorectal Cancer Screening Activities among Uninsured Individuals in Rural Northeast Texas.

Introduction: Adherence to colorectal cancer (CRC) screening recommendations allows for both prevention and early detection of the disease, yet approximately one-third of U.S. adults aged 50-75 years have not regularly received CRC screening. Screening rates are lower for uninsured and rural individuals. We examined the relationships between demographic factors, past CRC screening experience, family history of colon cancer, and preference for CRC screening (fecal immunochemical test [FIT] vs. colonoscopy) and completion of CRC screening in an ethnically diverse, largely rural sample, with a specific focus on uninsured individuals. Methods: Participants were 2,476 uninsured individuals (age, 45-75 years; 66% female) recruited from a community outreach program in northeast Texas. Variables included demographic factors and CRC health-related information. Chisquare tests and hierarchical logistic regression were used. Results: The CRC screening groups consisted of 1,413 who completed screening and 1,063 who did not. After controlling for demographic factors, participants who reported past CRC screening experience (odds ratio [OR] = 1.41, 95% confidence interval [CI] = 1.17, 1.71, p < 0.001) and chose colonoscopy (OR = 1.27, 95% CI = 1.04, 1.55, p = 0.019) had an increased likelihood of CRC screening completion. Conclusion: Educational programs coupled with financial support for screenings may help close the gap in screenings between minority racial/ethnic and gender groups. Participants with previous experience of CRC screening and preference for colonoscopy were associated with completing CRC screening. A focus on individuals' preferences for CRC screening may help develop and target appropriate intervention for promoting CRC screening. Further examination is warranted to determine the associations among various socio-demographic factors, lifestyle and behavioral factors, and psychosocial variables in this disadvantaged population. Moreover, intervention programs should raise awareness of the importance of family history of colon cancer. [ABSTRACT FROM AUTHOR]