Community-Based Colorectal Cancer Screening in a Rural Population: Who Returns Fecal Immunochemical Test (FIT) Kits?

J Rural Health. 2017 Sep;33(4):371-374. doi: 10.1111/jrh.12210. Epub 2016 Sep 21.

Abstract

Purpose: To determine the return rate of community-delivered fecal immunochemical test (FIT) kits in a rural population and to identify significant predictors of returning kits.

Methods: Residents were recruited in 8 rural Kentucky counties to enroll in the study and receive an FIT kit. Of 345 recruited, 82.0% returned an FIT kit from the point of distribution. These participants were compared to the remainder relative to age, sex, marital status, having an annual income below $15,000, not graduating from high school, not having a regular health care provider, not having health care coverage, being a current smoker, indicating current overweight or obese status, and a scale measure of fatalism pertaining to colorectal cancer. Predictors achieving significance at the bivariate level were entered into a stepwise logistic regression model to calculate adjusted OR and 95% CI.

Findings: The return rate was 82.0%. In adjusted analyses, those indicating an annual income of less than $15,000 were 2.85 times more likely to return their kits (95% CI: 1.56-5.24; P < .001). Also, those not perceiving themselves to be overweight/obese were 1.95 times more likely to return their kits (95% CI: 1.07-3.55; P = .029).

Conclusions: An outreach-based colorectal cancer screening program in a rural population may yield high return rates. People with annual incomes below $15,000 and those not having perceptions of being overweight/obese may be particularly likely to return FIT kits.

Keywords: access to care; colorectal cancer screening; epidemiology; fecal immunochemical testing; health disparities.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / epidemiology
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / statistics & numerical data
  • Female
  • Health Services Accessibility / standards
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Immunochemistry / instrumentation
  • Income / statistics & numerical data
  • Insurance, Health / statistics & numerical data
  • Kentucky / epidemiology
  • Male
  • Mass Screening / methods*
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Rural Population / statistics & numerical data*
  • Smokers / statistics & numerical data