TITLE:
Are symptoms of anxiety and depression associated with colorectal screening perceptions and behaviors among older adults in primary care?
AUTHORS:
Hind A. Beydoun, Suraj Khanal, May A. Beydoun, Alan B. Zonderman, Ravinder Mohan, Agatha Parks-Savage
KEYWORDS:
Anxiety; Behavior; Colorectal Cancer; Depression; Health Belief Model; Perception; Screening
JOURNAL NAME:
Open Journal of Preventive Medicine,
Vol.4 No.2,
February
13,
2014
ABSTRACT: Despite the existence
of colorectal cancer (CRC) screening guidelines, population-based studies have consistently shown under-utilization of CRC screening procedures among older adults in the United States. We examined
whether symptoms of anxiety and depression are associated with colorectal
cancer (CRC) screening perceptions and behaviors among older adults in a
primary care setting. A cross-sectional study was conducted by using a sample
of 143 family medicine patients who completed an 88-item anonymous
self-administered questionnaire covering symptoms of anxiety and depression
as well as CRC screening perceptions (defined based on the Health Belief Model)
and behaviors (defined as ever use of or adherence to CRC testing). Moderate-to-clinically
significant anxiety and depressive symptoms were, respectively, prevalent in
47% and 42% of participants. Perceived benefits and barriers were the only
Health Belief Model constructs associated with anxiety. Perceived barriers
were positively associated with anxiety
symptoms after adjustment for confounders, including age, gender,
race/ ethnicity, marital status, education, smoking history, body mass index
and self-rated health. By
contrast, perceived benefits were negatively associated with anxiety symptoms
only in the unadjusted model. Neither anxiety nor depression was associated
with ever use of or adherence to CRC testing. Symptoms of anxiety, but not
depression, may potentially influence CRC screening perceptions, with
implications for behavioral interventions targeting CRC testing.