Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 4/2009

01-12-2009

Association of health beliefs and colonoscopy use among survivors of colorectal cancer

Authors: Talya Salz, Noel T. Brewer, Robert S. Sandler, Bryan J. Weiner, Christopher F. Martin, Morris Weinberger

Published in: Journal of Cancer Survivorship | Issue 4/2009

Login to get access

Abstract

Objectives

Clinical practice guidelines recommend ongoing testing (surveillance) for colorectal cancer survivors because they remain at risk for both local recurrences and second primary tumors. However, survivors often do not receive colorectal cancer surveillance. We used the Health Belief Model (HBM) to identify health beliefs that predict intentions to obtain routine colonoscopies among colorectal cancer survivors.

Methods

We completed telephone interviews with 277 colorectal cancer survivors who were diagnosed 4 years earlier, between 2003 and 2005, in North Carolina. The interview measured health beliefs, past preventive behaviors, and intentions to have a routine colonoscopy in the next 5 years.

Results

In bivariate analyses, most HBM constructs were associated with intentions. In multivariable analyses, greater perceived likelihood of colorectal cancer (OR = 2.00, 95% CI = 1.16–3.44) was associated with greater intention to have a colonoscopy. Survivors who already had a colonoscopy since diagnosis also had greater intentions of having a colonoscopy in the future (OR = 9.47, 95% CI = 2.08–43.16).

Conclusions

Perceived likelihood of colorectal cancer is an important target for further study and intervention to increase colorectal cancer surveillance among survivors. Other health beliefs were unrelated to intentions, suggesting that the health beliefs of colorectal cancer survivors and asymptomatic adults may differ due to the experience of cancer.
Literature
1.
Cancer Facts & Figures—2008. 2008, American Cancer Society (ACS): Atlanta, Georgia.
2.
Green RJ, et al. Surveillance for second primary colorectal cancer after adjuvant chemotherapy: an analysis of Intergroup 0089. Ann Intern Med. 2002;136(4):261–9.PubMed
3.
Desch CE, et al. Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol. 2005;23(33):8512–9.CrossRefPubMed
4.
Rex DK, et al. Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2006;130(6):1865–71.CrossRefPubMed
5.
Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2003. CA Cancer J Clin. 2003;53(1):27–43.CrossRefPubMed
6.
Winawer S, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale—update based on new evidence. Gastroenterology. 2003;124(2):544–60.CrossRefPubMed
7.
The NCCN Colorectal Screening Clinical Practice Guidelines in Oncology (Version 1.2006). 2006, National Comprehensive Cancer Network.
8.
The NCCN Colorectal Screening Clinical Practice Guidelines in Oncology (Version 1.2005). 2005, National Comprehensive Cancer Network, Inc.
9.
Anthony T, et al. Practice parameters for the surveillance and follow-up of patients with colon and rectal cancer. Dis Colon Rectum. 2004;47(6):807–17.CrossRefPubMed
10.
Benson AB 3rd, et al. 2000 update of American Society of Clinical Oncology colorectal cancer surveillance guidelines. J Clin Oncol. 2000;18(20):3586–8.PubMed
11.
Simmang CL, et al. Practice parameters for detection of colorectal neoplasms. The Standards Committee, The American Society of Colon and Rectal Surgeons. Dis Colon Rectum. 1999;42(9):1123–9.CrossRefPubMed
12.
Cooper GS, Payes JD. Temporal trends in colorectal procedure use after colorectal cancer resection. Gastrointest Endosc. 2006;64(6):933–40.CrossRefPubMed
13.
Elston Lafata J, et al. Sociodemographic differences in the receipt of colorectal cancer surveillance care following treatment with curative intent. Med Care. 2001;39(4):361–72.CrossRefPubMed
14.
Rolnick S et al. Racial and age differences in colon examination surveillance following a diagnosis of colorectal cancer. J Natl Cancer Inst Monogr. 2005;(35):96–101.
15.
Rulyak SJ, et al. Clinical and sociodemographic factors associated with colon surveillance among patients with a history of colorectal cancer. Gastrointest Endosc. 2004;59(2):239–47.CrossRefPubMed
16.
Cooper GS, et al. Geographic and patient variation among Medicare beneficiaries in the use of follow-up testing after surgery for nonmetastatic colorectal carcinoma. Cancer. 1999;85(10):2124–31.CrossRefPubMed
17.
Knopf KB, et al. Bowel surveillance patterns after a diagnosis of colorectal cancer in Medicare beneficiaries. Gastrointest Endosc. 2001;54(5):563–71.CrossRefPubMed
18.
Ellison GL, et al. Racial differences in the receipt of bowel surveillance following potentially curative colorectal cancer surgery. Health Serv Res. 2003;38(6 Pt 2):1885–903.CrossRefPubMed
19.
Janz NK, Champion V, Strecher VJ. The health belief model. In: Glantz K, Rimer BK, Marcus Lewis F, editors. Health behavior and health education. San Francisco: Jossey-Bass; 2002. p. 45–66.
20.
Palmer RC, et al. Familial risk and colorectal cancer screening health beliefs and attitudes in an insured population. Prev Med. 2007;45(5):336–41.CrossRefPubMed
21.
Emmons KM, et al. Tailored computer-based cancer risk communication: correcting colorectal cancer risk perception. J Health Commun. 2004;9(2):127–41.CrossRefPubMed
22.
Macrae FA, et al. Predicting colon cancer screening behavior from health beliefs. Prev Med. 1984;13(1):115–26.CrossRefPubMed
23.
Codori AM, et al. Health beliefs and endoscopic screening for colorectal cancer: potential for cancer prevention. Prev Med. 2001;33(2 Pt 1):128–36.PubMed
24.
Gipsh K, Sullivan JM, Dietz EO. Health belief assessment regarding screening colonoscopy. Gastroenterol Nurs. 2004;27(6):262–7.CrossRefPubMed
25.
Janz NK, et al. Colorectal cancer screening attitudes and behavior: a population-based study. Prev Med. 2003;37(6 Pt 1):627–34.CrossRefPubMed
26.
Rawl S, et al. Validation of scales to measure benefits and barriers of colorectal cancer screening. J Psychosoc Oncol. 2001;19(3/4):47–63.CrossRef
27.
James AS, Campbell MK, Hudson MA. Perceived barriers and benefits to colon cancer screening among African Americans in North Carolina: how does perception relate to screening behavior? Cancer Epidemiol Biomarkers Prev. 2002;11(6):529–34.PubMed
28.
Katz ML, et al. Improving colorectal cancer screening by using community volunteers: results of the Carolinas cancer education and screening (CARES) project. Cancer. 2007;110(7):1602–10.CrossRefPubMed
29.
Mysliwiec P, Cronin K, Schatzkin A. Chapter 5: New malignancies following cancer of the colon, rectum, and anus. In: RE C, et al., editors. New malignancies among cancer survivors: SEER cancer registries, 1973–2000. Bethesda, MD: National Cancer Institute; 2006. p. 111–144.
30.
Sargent DJ, et al. Disease-free survival versus overall survival as a primary end point for adjuvant colon cancer studies: individual patient data from 20, 898 patients on 18 randomized trials. J Clin Oncol. 2005;23(34):8664–70.CrossRefPubMed
31.
Montano DE, Taplin SH. A test of an expanded theory of reasoned action to predict mammography participation. Soc Sci Med. 1991;32(6):733–41.CrossRefPubMed
32.
Mandelblatt J, et al. Targeting breast and cervical cancer screening to elderly poor black women: who will participate? The Harlem study team. Prev Med. 1993;22(1):20–33.CrossRefPubMed
33.
Myers RE, et al. Adherence by African American men to prostate cancer education and early detection. Cancer. 1999;86(1):88–104.CrossRefPubMed
34.
Sutton S, et al. Predictors of attendance in the United Kingdom flexible sigmoidoscopy screening trial. J Med Screen. 2000;7(2):99–104.CrossRefPubMed
35.
Andrykowski MA, et al. Factors associated with return for routine annual screening in an ovarian cancer screening program. Gynecol Oncol. 2007;104(3):695–701.CrossRefPubMed
36.
From Cancer Patient to Cancer Survivor: Lost in Transition, ed. M. Hewitt, S. Greenfield, and E. Stovall. 2006: Institute of Medicine and National Research Council.
37.
Earle CC. Failing to plan is planning to fail: improving the quality of care with survivorship care plans. J Clin Oncol. 2006;24(32):5112–6.CrossRefPubMed
38.
Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101(8):1712–9.CrossRefPubMed
39.
40.
Ayanian JZ, et al. Understanding Cancer Treatment and Outcomes: The Cancer Care Outcomes Research and Surveillance Consortium. J Clin Oncol. 2004;22(15):2992–2996.CrossRefPubMed
41.
Vernon SW, et al. Measures for ascertaining use of colorectal cancer screening in behavioral, health services, and epidemiologic research. Cancer Epidemiol Biomarkers Prev. 2004;13(6):898–905.PubMed
42.
Johnston A, et al. Validation of a comorbidity education program. J of Registry Management. 2001;28(3):125–131.
43.
Piccirillo J. Importance of comorbidity in head and neck cancer. Laryngoscope. 2000;110(4):593–602.CrossRefPubMed
44.
Piccirillo J, et al. The measurement of comorbidity by cancer registries. J of Registry Management. 2003;30(4):8–14.
45.
Royston P. Multiple imputation of missing values: Update of ice. Stata Journal. 2005;5(4):527–536.
46.
Royston P. Multiple imputation of missing values. Stata Journal. 2004;4(3):227–241.
47.
Stata Statistical Software: Release 10. StataCorp LP: College Station, TX, 2007.
48.
Hosmer DW, Lemeshow S. Applied logistic regression. 2nd ed. New York: Wiley-Interscience; 2000.
49.
Elston Lafata J, et al. Routine surveillance care after cancer treatment with curative intent. Med Care. 2005;43(6):592–9.CrossRefPubMed
50.
51.
Cardella J, et al. Compliance, attitudes and barriers to post-operative colorectal cancer follow-up. J Eval Clin Pract. 2008;14(3):407–15.CrossRefPubMed
52.
Lipkus IM, Green LG, Marcus A. Manipulating perceptions of colorectal cancer threat: implications for screening intentions and behaviors. J Health Commun. 2003;8(3):213–28.CrossRefPubMed
53.
Lipkus IM, et al. Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions. Prev Med. 2005;40(5):489–501.CrossRefPubMed
54.
Edwards AG et al. Personalised risk communication for informed decision making about taking screening tests. Cochrane Database Syst Rev. 2006;(4): p. CD001865.
55.
Friedman LC, Webb JA, Everett TE. Psychosocial and medical predictors of colorectal cancer screening among low-income medical outpatients. J Cancer Educ. 2004;19(3):180–6.CrossRefPubMed
56.
Christie J, et al. Predictors of endoscopy in minority women. J Natl Med Assoc. 2005;97(10):1361–8.PubMed
57.
Levy BT, et al. Colorectal cancer testing among patients cared for by Iowa family physicians. Am J Prev Med. 2006;31(3):193–201.CrossRefPubMed
58.
Menon U, et al. Beliefs associated with fecal occult blood test and colonoscopy use at a worksite colon cancer screening program. J Occup Environ Med. 2003;45(8):891–8.CrossRefPubMed
59.
Sheeran P. Intention-behavior relations: a conceptual and empirical review. In: Stroebe W, Hewstone M, editors. European Review of Social Psychology. John WIley and Sons; 2002. p. 1–36.
60.
Webb TL, Sheeran P. Does Changing Behavioral Intentions Engender Behavior Change? A meta-analysis of the experimental evidence. Psychol Bull. 2006;132(2):249–268.CrossRefPubMed
61.
Braithwaite RS, et al. A framework for tailoring clinical guidelines to comorbidity at the point of care. Arch Intern Med. 2007;167(21):2361–5.CrossRefPubMed
62.
Larkey LK, et al. Storytelling for promoting colorectal cancer screening among underserved Latina women: a randomized pilot study. Cancer Control. 2009;16(1):79–87.PubMed
63.
Makoul G, et al. A multimedia patient education program on colorectal cancer screening increases knowledge and willingness to consider screening among Hispanic/Latino patients. Patient Educ Couns, 2009.
64.
Schroy PC 3rd, et al. An effective educational strategy for improving knowledge, risk perception, and risk communication among colorectal adenoma patients. J Clin Gastroenterol. 2008;42(6):708–14.CrossRefPubMed
Metadata
Title
Association of health beliefs and colonoscopy use among survivors of colorectal cancer
Authors
Talya Salz
Noel T. Brewer
Robert S. Sandler
Bryan J. Weiner
Christopher F. Martin
Morris Weinberger
Publication date
01-12-2009
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 4/2009
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-009-0095-0

Other articles of this Issue 4/2009

Journal of Cancer Survivorship 4/2009 Go to the issue

OriginalPaper

Patterns of confidant use among patients and spouses in the year after breast cancer

OriginalPaper

Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response

OriginalPaper

A comparison of tobacco-related risk factors between preadolescents with and without cancer

OriginalPaper

Racial/ethnic differences in quality of life after diagnosis of breast cancer

OriginalPaper

Ethnicity and persistent symptom burden in breast cancer survivors

OriginalPaper

Longitudinal assessment of BMI in relation to ADT use among early stage prostate cancer survivors
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits