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Predictors of Colorectal Cancer Screening: Does Rurality Play a Role?
Author(s) -
Ojinnaka Chinedum O.,
Choi Yong,
Kum HyeChung,
Bolin Jane N.
Publication year - 2015
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/jrh.12104
Subject(s) - medicine , fecal occult blood , rurality , residence , logistic regression , colorectal cancer , behavioral risk factor surveillance system , environmental health , health care , colonoscopy , multivariate analysis , metropolitan area , rural area , gerontology , test (biology) , demography , cancer , population , pathology , paleontology , sociology , biology , economics , economic growth
Abstract Purpose The purpose of this study was to explore the associations between sociodemographic factors such as residence, health care access, and colorectal cancer (CRC) screening among residents of Texas. Methods Using the 2012 Behavioral Risk Factor Surveillance Survey, we performed logistic regression analyses to determine predictors of CRC screening among Texas residents, including rural versus urban differences. Our outcomes of interest were previous (1) CRC screening using any CRC test, (2) fecal occult blood test (FOBT), or (3) endoscopy, as well as up‐to‐date screening using (4) any CRC test, (5) FOBT, or (6) endoscopy. The independent variable of interest was rural versus urban residence; we controlled for other sociodemographic and health care access variables such as lack of health insurance. Results Multivariate analysis showed that individuals who were residents of a rural/non‐Metropolitan Statistical Area (MSA) location (OR = 0.70, 95% CI = 0.51‐0.97) or a suburban county (OR = 0.61, 95% CI = 0.39‐0.95) were less likely to report ever having any CRC screening compared to residents of a center city of an MSA. Residents of a rural/non‐MSA location were less likely (OR = 0.49, 95% CI = 0.28‐0.87) than residents of a center city of an MSA to be up‐to‐date using FOBT. There was decreased likelihood of ever being screened for CRC among the uninsured (OR = 0.43, 95% CI = 0.31‐0.59). Conclusions Effective development and implementation of strategies to improve screening rates should aim at improving access to health care, taking into account demographic characteristics such as rural versus urban residence.