Correlates of colorectal cancer testing in Massachusetts men and women

Background. Colorectal cancer (CRC) is a leading cause of cancer-related death. Although CRC screening can reduce CRC mortality, it is underutilized. We examined the association between personal and health care characteristics and CRC testing, defined as being current on any test that meets CRC screening guidelines. Methods. The current investigation relies on questionnaire data from the 1999 Massachusetts Behavioral Risk Factor Surveillance System and a CRC call-back survey of 869 Behavioral Risk Factor Surveillance System participants age 50 and older. Multivariate logistic regression was used to identify predictors of CRC testing. All analyses were stratified by gender. Results. Men were more likely than women to be currently tested for CRC. Physician recommendation for testing was strongly associated with testing among men and women, but among those with a recommendation, men were more likely to be tested than women. Older age, usually having an annual check-up, and HMO membership were associated with CRC testing among men and women. Perceived high risk of CRC was more strongly associated with testing among men, while other cancer screening was more strongly associated with testing among women. Conclusion. There are important gender differences in the prevalence of CRC testing and in factors associated with testing. Research into understanding gender differences related to compliance with physician recommendations is warranted. (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved.