Modifiable patient-reported factors associated with cancer-screening knowledge and participation in a community-based health assessment - 16/03/23

Doi : 10.1016/j.amjsurg.2022.10.059

Oluwadamilola M. Fayanju ^a,^b,^c,^d,^e,^{^{1
Division of Breast Surgery, Department of Surgery, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104.},}^{^{2
Rena Rowan Breast Center, Abramson Cancer Center, Philadelphia, PA 19104.},}^{^{3
Penn Center for Cancer Care Innovation (PC3I), The University of Pennsylvania, Philadelphia, PA 19104.},}^{^{4
Leonard Davis Institute of Health Economics (LDI), The University of Pennsylvania, Philadelphia, PA 19104.},}^⁎ , Taofik Oyekunle ^b,^e, Samantha M. Thomas ^b,^f, Kearston L. Ingraham ^b, Laura J. Fish ^b,^g, Rachel A. Greenup ^a,^b,^c,^h,^{^{5
Division of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, CT 06520.},}^{^{6
The Breast Center at Smilow Cancer Hospital at Yale New Haven, New Haven CT 06511.}}, Kevin C. Oeffinger ^b,ⁱ, S. Yousuf Zafar ^b,^c,^h,^i,^j, Terry Hyslop ^b,^f,^{^{7
Cancer Risk and Control Program, Sidney Kimmel Cancer Center at Thomas Jefferson University, 233 S 10th St, Philadelphia, PA 19107.}}, E. Shelley Hwang ^a,^b, Steven R. Patierno ^b,ⁱ, Nadine J. Barrett ^b,^g,^k
^a Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA
^b Duke Cancer Institute, Durham, NC, 27710, USA
^c Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA
^d Duke Forge, Duke University, Durham, NC, 27710, USA
^e Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA
^f Department of Biostatistics and Bioinformatics, Duke University Medical Center, Box 2717, Durham, NC, 27710, USA
^g Department of Family Medicine and Community Health, Duke University Medical Center, Box 2914, Durham, NC, 27710, USA
^h Duke Margolis Center for Health Policy, Duke University, Durham, NC, 27708, USA
ⁱ Department of Medicine, Duke University Medical Center, Box 3893, Durham, NC, 27710, USA
^j Change Healthcare, 216 Centerview Dr #300, Nashville, TN, 37219, USA
^k Duke Clinical and Translation Science Institute, Duke University School of Medicine, Durham, NC, 27710, USA

^∗Corresponding author. 3400 Spruce St, Silverstein 4, Philadelphia, PA, 19104, USA.3400 Spruce StSilverstein 4PhiladelphiaPA19104USA

Abstract

Background

We sought to identify modifiable factors associated with cancer screening in a community-based health assessment.

Methods

24 organizations at 47 community events in central North Carolina distributed a 91-item survey from April–December 2017. Responses about (1) interest in disease prevention, (2) lifestyle choices (e.g., diet, tobacco), and (3) perceptions of primary care access/quality were abstracted to examine their association with self-reported screening participation and knowledge about breast, prostate, and colorectal cancer.

Results

2135/2315 participants (92%; 38.5% White, 38% Black, 9.9% Asian) completed screening questions. >70% of screen-eligible respondents reported guideline-concordant screening. Healthy dietary habits were associated with greater knowledge about breast and colorectal cancer screening; reporting negative attitudes about and barriers to healthcare were associated with less breast, prostate, and colorectal cancer screening. Having a place to seek medical care (a proxy for primary care access) was independently associated with being ∼5 times as likely to undergo colorectal screening (OR 4.66, 95% CI 1.58–13.79, all p < 0.05).

Conclusions

In this diverse, community-based sample, modifiable factors were associated with screening engagement, highlighting opportunities for behavioral intervention.

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Highlights

•	We conducted a community-based assessment of cancer screening in North Carolina.
•	24 organizations at 47 events distributed a 91-item survey to >2000 adults.
•	Healthy diets were associated with greater breast & colorectal screening knowledge.
•	Negative attitudes about & barriers to care were associated with less screening.
•	Having a place to seek medical care predicted greater odds of colorectal screening.

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Keywords : Breast cancer, Colorectal cancer, Prostate cancer, Cancer screening, Health equity, Modifiable risk factors

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Vol 225 - N° 4

P. 617-629 - avril 2023 Retour au numéro

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To screen or not to screen: A key decision that reflects health literacy and trust
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Modifiable patient-reported factors associated with cancer-screening knowledge and participation in a community-based health assessment - 16/03/23

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