Predictors of colon cancer screening among low-income urban minority residents: The Cancer Risk Assessment in Baltimore (CRAB) Study

4101 Background: Colorectal cancer mortality can be reduced through early detection, using recommended screening tests (fecal occult blood test (FOBT), sigmoidoscopy, or colonoscopy). However, screening is underutilized, especially among low-income and racial/ethnic minority groups. Few studies have examined determinants of screening in these groups. Methods: We analyzed data on predictors of colon cancer screening from a cross-sectional study of Baltimore City Residents (N = 534). Participants responded to a questionnaire administered by an interviewer, on screening practices, behavioral, social and demographic factors, including income level. Eligible respondents for this analysis were age = 50, aware of colorectal screening tests, but not diagnosed with colon polyps or cancer. Multivariate techniques were used to examine predictors of having undergone any recommended colon cancer screening test. Results: The eligible population for this analysis (N=202) was 49.0 % male and 51.0 % female. The median income fell within the $12,000-$24,999 bracket. The proportion of participants that had received colon cancer screening was 34.5 % among those in the highest income bracket (i.e. =$25,000) compared to 30.0 % in the lowest income bracket (i.e. =$11,999). This difference was statistically significant after adjusting for other sociodemographic factors (odds ratio (OR)=3.12, p=0.023). Multivariate analysis indicated that screening was associated with having one (OR: 3.56, p=0.016) or more than one (OR: 7.31, p=0.006) primary health care provider. Having health care coverage, a doctor who recommended exercise, and having at least some college education, were also associated with screening. Conclusions: Negative predictors of colorectal cancer screening include: extremely low income levels (= $11,999), lack of health care coverage, primary care providers, and college education level. Provider recommendations for healthy behaviors (e.g. exercise) are associated with patient adherence to recommended cancer screenings. The design of interventions to promote use of screening tests by low-income populations should be informed by the substantial heterogeneity in patient and provider characteristics within these populations. No significant financial relationships to disclose.