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Self-efficacy determines patient’s likelihood for colorectal cancer screening

A patient feeling in control of scheduling and planning a colorectal screening exam were some of the most important factors in determining if they underwent the procedure, according to research recently published in the American Journal of Preventive Medicine.

“[Colorectal cancer screening] rates have increased from 20% in 1997 to nearly 65% in 2010. However, many eligible adults remain unscreened,” Masahito Jimbo, MD, PhD, MPH, of the department of family medicine at the University of Michigan, and colleagues wrote. “This disconnect may arise from physician recommendation not matching the patient’s preference, leading to lower [colorectal cancer screening] adherence rates. By contrast, a preference-based tailored navigation intervention significantly increased [colorectal cancer screening rates].”

To increase the evidence base on which factors determine if a patient gets screened, researchers conducted a formal mediation analysis on 570 adults aged 50 to 75 years old, then performed mediation, regression and confirmatory analyses on cross-sectional data. The mean age of the participants was 57.7 years, 55.1% were white and 56.1% were women.

Jimbo and colleagues found that women were less likely than men to perceive their risk for colorectal cancer as high or moderate(OR = 0.68; 95% CI, 0.47-0.97). Women were also at significantly lower odds than men at perceiving themselves to have high self-efficacy (OR = 0.59; 95% CI, 0.42-0.85). Whites had lower odds than blacks of having high self-efficacy (OR = 0.37; 95% CI, 0.25-0.57) and intent to undergo colorectal cancer screening (OR = 0.53; 95% CI, 0.34-0.84). Medium/high vs. low self-efficacy, lower level of test worries, higher knowledge and younger age increased the odds of intent of being screened. Self-efficacy, but not perceived risk, significantly mediated the association between race, attitude, and test worries and patient screening intent.

“Neither self-efficacy nor perceived risk significantly mediated for [colorectal cancer screening] test preference. This suggests that test preference is not driven by sociobehavioral factors that affect intent and that other factors not identified in this study may affect it,” Jimbo and colleagues wrote. “Decision aids and behavioral interventions andpolicies to increase [colorectal cancer screenings] should focus on positively influencing knowledge, attitude, and worries to improve self-efficacy and increase patient intent to undergo [colorectal cancer screening]. – by Janel Miller

Disclosure: The researchers reported no relevant financial disclosures.