Modifiable patient-reported factors associated with cancer-screening knowledge and participation in a community-based health assessment

Oluwadamilola M Fayanju; Taofik Oyekunle; Samantha M Thomas; Kearston L Ingraham; Laura J Fish; Rachel A Greenup; Kevin C Oeffinger; S Yousuf Zafar; Terry Hyslop; E Shelley Hwang; Steven R Patierno; Nadine J Barrett

doi:10.1016/j.amjsurg.2022.10.059

Modifiable patient-reported factors associated with cancer-screening knowledge and participation in a community-based health assessment

Am J Surg. 2023 Apr;225(4):617-629. doi: 10.1016/j.amjsurg.2022.10.059. Epub 2022 Nov 2.

Authors

Affiliations

¹ Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA; Duke Cancer Institute, Durham, NC, 27710, USA; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA; Duke Forge, Duke University, Durham, NC, 27710, USA; Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA. Electronic address: fayanju@upenn.edu.
² Duke Cancer Institute, Durham, NC, 27710, USA; Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA.
³ Duke Cancer Institute, Durham, NC, 27710, USA; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Box 2717, Durham, NC, 27710, USA.
⁴ Duke Cancer Institute, Durham, NC, 27710, USA.
⁵ Duke Cancer Institute, Durham, NC, 27710, USA; Department of Family Medicine and Community Health, Duke University Medical Center, Box 2914, Durham, NC, 27710, USA.
⁶ Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA; Duke Cancer Institute, Durham, NC, 27710, USA; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA; Duke Margolis Center for Health Policy, Duke University, Durham, NC, 27708, USA.
⁷ Duke Cancer Institute, Durham, NC, 27710, USA; Department of Medicine, Duke University Medical Center, Box 3893, Durham, NC, 27710, USA.
⁸ Duke Cancer Institute, Durham, NC, 27710, USA; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA; Duke Margolis Center for Health Policy, Duke University, Durham, NC, 27708, USA; Department of Medicine, Duke University Medical Center, Box 3893, Durham, NC, 27710, USA; Change Healthcare, 216 Centerview Dr #300, Nashville, TN, 37219, USA.
⁹ Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA; Duke Cancer Institute, Durham, NC, 27710, USA.
¹⁰ Duke Cancer Institute, Durham, NC, 27710, USA; Department of Family Medicine and Community Health, Duke University Medical Center, Box 2914, Durham, NC, 27710, USA; Duke Clinical and Translation Science Institute, Duke University School of Medicine, Durham, NC, 27710, USA.

Abstract

Background: We sought to identify modifiable factors associated with cancer screening in a community-based health assessment.

Methods: 24 organizations at 47 community events in central North Carolina distributed a 91-item survey from April-December 2017. Responses about (1) interest in disease prevention, (2) lifestyle choices (e.g., diet, tobacco), and (3) perceptions of primary care access/quality were abstracted to examine their association with self-reported screening participation and knowledge about breast, prostate, and colorectal cancer.

Results: 2135/2315 participants (92%; 38.5% White, 38% Black, 9.9% Asian) completed screening questions. >70% of screen-eligible respondents reported guideline-concordant screening. Healthy dietary habits were associated with greater knowledge about breast and colorectal cancer screening; reporting negative attitudes about and barriers to healthcare were associated with less breast, prostate, and colorectal cancer screening. Having a place to seek medical care (a proxy for primary care access) was independently associated with being ∼5 times as likely to undergo colorectal screening (OR 4.66, 95% CI 1.58-13.79, all p < 0.05).

Conclusions: In this diverse, community-based sample, modifiable factors were associated with screening engagement, highlighting opportunities for behavioral intervention.

Keywords: Breast cancer; Cancer screening; Colorectal cancer; Health equity; Modifiable risk factors; Prostate cancer.

MeSH terms

Colorectal Neoplasms* / diagnosis
Colorectal Neoplasms* / prevention & control
Early Detection of Cancer*
Humans
Male
Mass Screening
North Carolina
Patient Reported Outcome Measures
Surveys and Questionnaires

Abstract

MeSH terms

Grants and funding