COLORECTAL CANCER SCREENING IN EASTLAND & LIMESTONE, TEXAS: PATIENT AWARENESS

Purpose: The U.S. Preventive Services Task Force (USPSTF) has designated colorectal cancer screening as a Grade "A" recommendation. Despite such strong recommendations, recent studies indicate that rural populations are being screened less successfully than urban populations. The studies show that colorectal cancer screening detects more advanced disease in rural populations than in urban populations. Previous studies have also identified different factors affecting colorectal cancer screening, one of them being knowledge about colorectal cancer and screening guidelines. The purpose of this study was to assess the relationship between knowledge of colorectal cancer and knowledge of colorectal cancer screening with actual screening by colonoscopy in a patient population in Eastland and Limestone Counties. Methods: A cross-sectional study was conducted by administering a survey to assess citizen's public knowledge concerning colorectal cancer and screening. The survey consisted of questions related to colorectal cancer screening knowledge and behaviors. Questions were taken from the Behavioral Risk Factor Surveillance System Survey, as well as other published literature regarding knowledge of colorectal cancer. The survey also contained demographic information. Participants age 18 and older were recruited in primary care clinics in Eastland and Limestone Counties. Descriptive statistics were performed for demographic variables (gender, age). A knowledge of colorectal carcinoma (CRC) score and a knowledge of CRC Screening were calculated. Logistic regression was performed to analyze the relationship between both types of knowledge and being screened by colonoscopy. Results: Of the 109 respondents, 68.8% ( n= 75) were 50 years or older and 72.5% (n=79) were female while 25.7% (n=28) were male. In this study 58.5% scored the survey maximum score of 3 for Knowledge of CRC and 19.8% the maximum score of 5 for knowledge of CRC screening. The odds of being screened by either colonoscopy or sigmoidoscopy in those 50 years or older significantly increased (OR = 1.82; 95% Confidence Interval [CI], 1.08 to 3.05) when combined knowledge score of respondents increased by one unit. The odds for screening is also increased significantly (OR = 11.9; 95% CI, 1.06 to 132.7) in those employed compared to those not employed. Conclusions: The results show that colorectal screening was higher in respondents with greater knowledge about CRC and CRC screening.