Barriers to colorectal cancer screening: A case-control study

Table 1 Characteristics of subjects between case and control groups¹

Characteristic	Case	Control 1	Control 2	P-value
Age (mean ± SD, yr)	53.3 ± 9.0	54.3 ± 8.3	52.7 ± 9.7	0.23
Gender
Male	47	70	98
Female	39	94	115	0.19
Marital status
Ever	83	163	208
Never	3	1	5	0.25
Occupation
Worker	19	65	69
Official/administrator	3	3	9
Technician/professional	7	8	6
Businessman	8	11	11
Other	49	77	18	0.08
Education
College & above	12	18	23
High school	17	29	34
Middle school	45	94	132
Elementary school or none	12	23	24	0.65
Personal income2
≤ ¥10 000	53	92	134
¥10 001-20 000	21	45	51
> ¥20 000	9	16	21	0.53

¹Definition: case, those completing both a fecal occult blood test (FOBT) and colonoscopy; control 1, those having a positive FOBT but refusing a colonoscopy, and control 2, those who refused both an FOBT and colonoscopy in a CRC screening program in 2004.

²Estimated by yearly household income in Chinese Dollar (Yuan) divided by total number of family members.

Table 2 Differences by gender in association of occupation and willingness to attend a colorectal screening program

	OR1 (95% CI)1			OR2 (95% CI)1			OR3 (95% CI)1
	Together2	Male	Female	Together2	Male	Female	Together2	Male	Female
Occupation
Worker	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Official/administrator	3.42 (0.64-18.36)	4.13 (0.55-31.26)	-	1.21 (0.30-4.92)	3.40 (0.49-23.65)	0.50 (0.05-4.67)	2.83 (0.73-10.90)	1.22 (0.25-5.87)	-
Technician/professional	2.99 (0.96-9.32)	15.5 (2.34-102.85)	0.81 (0.15-4.51)	4.24 (1.27-14.11)	6.80 (1.44-32.20)	5.00 (0.42-59.66)	0.71 (0.23-2.15)	2.28 (0.41-12.61)	0.16 (0.02-1.42)
Businessman	2.49 (0.88-7.07)	12.4 (2.32-66.35)	0.61 (0.11-3.22)	2.64 (0.93-7.49)	8.16 (1.80-37.06)	0.83 (0.15-4.64)	0.94 (0.38-2.32)	1.52 (0.34-6.89)	0.73 (0.23-2.32)
Other	2.18 (1.17-4.06)	5.8 (1.99-16.94)	1.06 (0.47-2.38)	1.51 (0.82-2.77)	3.94 (1.39-11.21)	0.74 (0.33-1.63)	1.44 (0.93-2.25)	1.47 (0.76-2.85)	1.44 (0.79-2.62)
Gender
Male	1.00			1.00			1.00
Female	0.62 (0.37-1.04)			0.71 (0.43-1.17)			0.87 (0.58-1.32)
P for heterogeneity	0.009			0.01			0.80

¹OR1: Odds ratio for case versus control 1; OR2: Odds ratio for case versus control 2; OR3: Odds ratio for comparison between two control groups; 95% CI means 95% confidence interval.

²OR’s in all means only occupation and gender factors were single in the models, or called a single OR.

Table 3 Status of knowledge about colorectal cancer and its screening between case and control groups

Item1	Case	Control 1	Control 2	OR1 (95% CI)2		OR2 (95% CI)2		OR3 (95% CI)2
				Single	Multiple	Single	Multiple	Single	Multiple
Question 1
Yes, certain	57	84	68	1.0	1.0	1.0	1.0	1.0	1.0
Heard of it	14	30	77	0.69 (0.34-1.41)	0.50 (0.21-1.17)	0.22 (0.11-0.42)	0.15 (0.07-0.33)	3.17 (1.87-5.38)	2.90 (1.62-5.21)
I don’t know	15	50	68	0.44 (0.23-0.86)	0.22 (0.09-0.56)	0.45 (0.24-0.84)	0.24 (0.10-0.54)	1.68 (1.03-2.73)	1.49 (0.80-2.80)
Question 2
Yes, a lot	65	88	78	1.0	1.0	1.0	1.0	1.0	1.0
Yes, some	20	71	131	0.38 (0.21-0.68)	0.25 (0.12-0.54)	0.18 (0.10-0.32)	0.13 (0.06-0.27)	2.06 (1.35-3.13)	2.06 (1.21-3.50)
No	0	5	3	-	-	-	-	0.67 (0.15-2.89)	0.52 (0.11-2.56)
Question 3
Yes, certain	41	55	54	1.0	1.0	1.0	1.0	1.0	1.0
Yes, possible	45	94	151	0.64 (0.37-1.10)	0.71 (0.36-1.39)	0.40 (0.24-0.67)	0.38 (0.20-0.72)	1.61 (1.02-2.53)	1.77 (1.04-3.02)
No, impossible	0	15	7	-	-	-	-	0.47 (0.18-1.23)	0.43 (0.14-1.38)
Question 4
Yes	79	138	153	1.0	1.0	1.0	1.0	1.0	1.0
No	0	7	6	-	-	-	-	2.50 (1.41-4.43)	2.11 (1.12-3.99)
Don’t care	7	19	53	0.64 (0.26-1.60)	0.58 (0.20-1.70)	0.26 (0.11-0.59)	0.25 (0.10-0.62)	0.77 (0.25-2.34)	0.68 (0.21-2.23)
Question 5
Community	81	160	197	1.0	1.0	1.0	1.0	1.0	1.0
News media	4	3	9	2.65 (0.58-12.13)	2.52 (0.44-14.49)	1.07 (0.32-3.56)	1.22 (0.32-4.60)	2.48 (0.66-9.33)	2.79 (0.67-11.58)
Both	1	1	5	1.99 (0.12-32.19)	2.43 (0.08-75.03)	0.40 (0.05-3.38)	0.40 (0.03-4.54)	4.97 (0.59-41.70)	4.11 (0.47-36.29)

¹Question 1: Do you think colorectal cancer is a common cancer? Question 2: Do you think this screening will help you improve your awareness of health? Question 3: Do you think this screening can find an early stage of colorectal cancer? Question 4: Do you think it is necessary to conduct the colorectal cancer screening in your community? Question 5: How do you know this screening program? Community means community screening center;

²All single OR’s means without adjustment for any other factors in the model, and all multiple OR’s means with adjustment for the following factors including age (0 = < 45, 1 = 45-49, 2 = 50-54, 3 = 55-59, 4 = 60-64, 5 = 65-69, and 6 = ≥ 70), gender (0 = male and 1 = female), occupation (0 = worker, 1 = official/administrator, 2 = technician/professional, 3 = businessman, and 4 = others), interaction term between gender and occupation, and annual personal income (0 = < ¥10 000, 1 = ¥10,000-< 20 000, and 2 = ≥ ¥20 000); all variables were treated as dummy variables in the logistic regression model.

Table 4 Attendance inclination of colorectal cancer screening with different payment methods between case and control groups

Inclination to attend	Case	Control 1	Control 2	OR1 (95% CI)		OR2 (95% CI)		OR3 (95% CI)
				Single	Multiple	Single	Multiple	Single	Multiple
If FOBT self-paid
Yes	45	84	99	1.0	1.0	1.0	1.0	1.0	1.0
No	37	73	107	0.95 (0.55-1.62)	0.98 (0.53-1.79)	0.76 (0.46-1.27)	0.66 (0.37-1.19)	1.24 (0.82-1.89)	1.37 (0.86-2.19)
Refused1	4	7	7
If free colonoscopy
Yes	81	132	162	1.0	1.0	1.0	1.0	1.0	1.0
No	2	29	24	0.11 (0.03-0.48)	0.10 (0.02-0.45)	0.17 (0.04-0.72)	0.14 (0.03-0.65)	0.67 (0.37-1.21)	0.70 (0.36-1.35)
Refused1	3	3	27
If colonoscopy self-paid
Yes	57	85	93	1.0	1.0	1.0	1.0	1.0	1.0
No	23	66	82	0.52 (0.29-0.93)	0.50 (0.26-0.97)	0.46 (0.26-0.81)	0.43 (0.23-0.80)	1.14 (0.73-1.76)	1.12 (0.68-1.83)
Refused1	6	13	38

¹Refers to those who refused to answer this question; results in this row not concluded in statistical analysis.