Predictors of Cancer Prevention Attitudes and Participation in Cancer Screening Examinations

Background: Few current data are available regarding factors associated with participation in cancer screening examinations in the general population.

Methods: To identify factors associated with participation in cancer screening examinations, random population samples of 25- to 74-year-old men and women in six various-sized communities in three upper-Midwestern states (n = 4,915) were surveyed in 1987-1989. Multivariate-adjusted means were calculated and compared using analysis of covariance.

Results: Statistically significant (P < 0.05) strong predictors (other than age and sex) of ever having had a specific cancer screening test were as follows (the numbers in parentheses following each listed association are the absolute maximum differences in mean proportions among the levels of the predictors): (1) rectal examination: higher education (14%); (2) fecal occult blood testing: higher education (6%) and never smoker (5%); (3) sigmoidoscopy: higher income (7%) and higher education (6%); and (5) mammography: higher income (25%), higher education (8%), and a positive family history of breast cancer (7%). There were no strong predictors (out of nine) of ever having had a Papanicolaou smear or a breast self-examination.

Conclusions: The largest differences among the population for participation in cancer screening examinations involves income and the two most expensive cancer screening tests: higher income is a strong predictor of having a mammogram and, to a lesser extent, of having a sigmoidoscopy. The most consistent predictor of participation in cancer screening examinations across all cancer screening tests is education: higher education is a predictor of having each kind of cancer screening test.