Comparison of colorectal cancer screening practices between rural and urban providers

by Pedersen, Katherine Lynn.

Pedersen Katherine L~nn (Last Name) (First Name) (Initial) Comparison of Colorectal Cancer Screening Practices between Rural and Urban Providers (Title) Master of Science Degree in Applied Psychology (Graduate Major) Dr. Gorbatenko-Roth December, 2005 76 Pages (Name of Advisor) (MonthIYear) (No. of Pages) American Psychological Association, 5th edition (Name of Style Manual Used in Study) Although colorectal cancer screening has proven to reduce mortality rates from colorectal cancer, there still remains to be a relatively low percent of people participating in preventative measures specific to colorectal cancer. National data shows that less than half of adults aged 50 years or older have ever been screened for colorectal cancer, only 26% had a fecal occult blood test in the past two years and 53% ever having a sigmoidoscopy or colonoscopy (National Center for Chronic Disease Prevention and Health, 2004). In Wisconsin, approximately 27% of similarly aged adults report having a fecal occult blood test; 59% a sigmoidoscopy or colonoscopy (National Center for Chronic Disease Prevention and Health, 2004). Even though numbers in Wisconsin are higher than the national average, the numbers are still lower than the desired 75% (American Cancer Society Challenge Goals, Principles, & Nationwide Objectives, 1996). An obvious major determinant in frequency of colorectal screening is access to health care. One subpopulation for which access to health care is often an issue includes those living in rural areas. Specifically, rural areas have the potential for decreased access to screening due to physical proximity limitations, lack of specialists in the area, and appropriatehealth insurance. The purpose of this study was twofold: first to examine if any differences exist between rural and urban providers' colorectal cancer screening practices and attitudes; second, to identify factors that account for such differences. Findings from this study suggest that there are significant differences between rural and urban providers' colorectal cancer screening practices. Interestingly, the differences were not found in the overall frequency rate of screening (61 % rural; 68% urban), but in the method of screening. Rural providers had a statistically significant higher rate of screening with FOBT and urban providers with colonoscopy, even though both rural and urban providers perceived their patients to prefer a colonoscopy over FOBT screening.