Psychological and Behavioral Factors Associated with Colorectal Cancer Screening among Ashkenazim

Background. Psychological and behavioral factors related to annual colorectal cancer (CRC) screening were examined in a sample of Ashkenazi Jewish indi viduals. Identification of factors related to regular CRC screening in this population is important because of the possibility of a heightened incidence of CRC. Methods. Eligible participants were 171 Ashkenazi Jewish adults 40 years or older attending an educa tional program about breast cancer genetics. Compli ance with recommended guidelines for digital rectal examination and fecal occult blood test in the past year were dependent measures. Demographic variables, family history of CRC, perceived risk, physician recom mendation, and worry about cancer were indepen dent measures. Results. Digital rectal examinations and fecal occult blood tests had been obtained in the past year by 46 and 31% of the participants, respectively. A logistic re gression showed that physician recommendation was related significantly to obtaining digital rectal exami nations. Physician recommendation and education were related significantly to obtaining fecal occult blood tests. Although participants with family histor ies of CRC perceived themselves as being at increased risk of developing CRC, and were more worried about developing colon cancer, they were no more likely to adhere to CRC screening guidelines than those without such histories. Conclusions. Overall, compliance with recommended CRC screening was low even among high-risk individu als. Physicians play a key role in motivating people to comply with CRC screening. Physicians need to en courage all asymptomatic patients 50 years and older to be screened for CRC.