TITLE:
Predictors of Low Colorectal Cancer Screening in an Urban Academic Family Practice
AUTHORS:
Shaelyn Culleton, Morgan Slater, Aisha Lofters
KEYWORDS:
Colorectal Neoplasms, Early Detection of Cancer, Vulnerable Population, Secondary Prevention
JOURNAL NAME:
Open Journal of Preventive Medicine,
Vol.4 No.6,
June
11,
2014
ABSTRACT: Purpose: The primary objective was to describe the specific
socio-demographic variables that are associated with colorectal cancer (CRC)
under-screening in an urban, inner city population. The secondary objective was
to determine the overall proportion of eligible patients who are not appropriately
screened. Methods: A retrospective chart review of patients eligible for
average-risk CRC screening as per Ontario’s ColonCancerCheck program guidelines
was conducted at an academic, inner city family health practice associated
with St. Michael’s Hospital in Toronto, Ontario. Simple measures of
association, including t-tests and chi-square tests, were used to determine the
relationships between screening and demographic characteristics. Based on a
type I error rate of 0.05 and an appropriate sample size, the calculated power
for this study was 0.82. Results: A total of 200 patients were randomly selected; 54% were male;
the majority were non-immigrants (77.5%) and were employed or retired (76.5%).
Fifty-five percent of screened patients were up to date as per guidelines;
29.5% and 31% were up to date with a fecal occult blood test or a colonoscopy
respectively. Individuals with psychiatric illness (p = 0.0005), with no
history of prior cancer screening for other cancers (p = 0.0001), on disability
or unemployed (p = 0.0010), or who were younger (p = 0.0062) were significantly
less likely to undergo CRC screening. Conclusion: Colorectal cancer screening rates at
this academic, urban family practice were very similar to province wide
screening rates. Future studies should focus on group specific interventions to
increase CRC screening uptake in low CRC screened populations.