Abstract
Background: Guidelines of the American Cancer Society and US Preventive Services Task Force specify that colorectal cancer (CRC) screening using guaiac-based fecal occult blood test (FOBT)/fecal immunochemical test (FIT) should be done at home. We therefore examined the prevalence and correlates of CRC screening using FOBT/FIT in physicians' office vs at home. Methods: Analysis of 9493 respondents 50-75 years old from the Cancer Control Supplement of the 2015 National Health Interview Survey was conducted. Weighted multivariable logistic regression was used to identify the determinants of in-office vs home use of FOBT/FIT for CRC screening. Results: Of the overall sample of screening-eligible adults (n = 9403), only 937 (10.4%) respondents underwent CRC screening using FOBT/FIT within the past year; among this screening population, 279 (28.3%) respondents were screened in-office. We found that sociodemographic factors alone, not CRC risk factors, determined whether FOBT/FIT would be used in-office or at home. Hispanics had greater odds of being screened in-office using FOBT/FIT (aOR: 2.04; 95% CI: 1.05-3.99). Compared with those 50-59 years old, respondents 70-75 years old were less likely to be screened in-office using FOBT/FIT (aOR: 0.44, 95% CI: 0.25-0.79). Similarly, individuals residing in the Western region of the country had lower odds of in-office FOBT/FIT (aOR: 0.26; 95% CI: 0.11-0.58). Conclusion: Amid low overall uptake rates of FOBT/FIT in the United States, in-physician office testing is high, indicative of a missed opportunity for effective screening and poor adherence of physicians to national guidelines. Sociodemographic factors are determinants of uptake of FOBT/FIT at home or in-office and should be considered in designing interventions aimed at providers and the general population.
Original language | English (US) |
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Pages (from-to) | 7408-7418 |
Number of pages | 11 |
Journal | Cancer medicine |
Volume | 8 |
Issue number | 17 |
DOIs | |
State | Published - Dec 1 2019 |
Keywords
- cancer screening
- colorectal cancer
- disparities
- fecal occult blood test (FOBT)/fecal immunochemical test (FIT)
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Cancer Research
MD Anderson CCSG core facilities
- Biostatistics Resource Group