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Modifiable patient-reported factors associated with cancer-screening knowledge and participation in a community-based health assessment

  • Author Footnotes
    1 Division of Breast Surgery, Department of Surgery, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104.
    ,
    Author Footnotes
    2 Rena Rowan Breast Center, Abramson Cancer Center, Philadelphia, PA 19104.
    ,
    Author Footnotes
    3 Penn Center for Cancer Care Innovation (PC3I), The University of Pennsylvania, Philadelphia, PA 19104.
    ,
    Author Footnotes
    4 Leonard Davis Institute of Health Economics (LDI), The University of Pennsylvania, Philadelphia, PA 19104.
    Oluwadamilola M. Fayanju
    Correspondence
    Corresponding author. 3400 Spruce St, Silverstein 4, Philadelphia, PA, 19104, USA.
    Footnotes
    1 Division of Breast Surgery, Department of Surgery, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104.
    2 Rena Rowan Breast Center, Abramson Cancer Center, Philadelphia, PA 19104.
    3 Penn Center for Cancer Care Innovation (PC3I), The University of Pennsylvania, Philadelphia, PA 19104.
    4 Leonard Davis Institute of Health Economics (LDI), The University of Pennsylvania, Philadelphia, PA 19104.
    Affiliations
    Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA

    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA

    Duke Forge, Duke University, Durham, NC, 27710, USA

    Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA
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  • Taofik Oyekunle
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Durham VA Medical Center, 508 Fulton St, Durham, NC, 27705, USA
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  • Samantha M. Thomas
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Biostatistics and Bioinformatics, Duke University Medical Center, Box 2717, Durham, NC, 27710, USA
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  • Kearston L. Ingraham
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA
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  • Laura J. Fish
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Family Medicine and Community Health, Duke University Medical Center, Box 2914, Durham, NC, 27710, USA
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  • Author Footnotes
    5 Division of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, CT 06520.
    ,
    Author Footnotes
    6 The Breast Center at Smilow Cancer Hospital at Yale New Haven, New Haven CT 06511.
    Rachel A. Greenup
    Footnotes
    5 Division of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, CT 06520.
    6 The Breast Center at Smilow Cancer Hospital at Yale New Haven, New Haven CT 06511.
    Affiliations
    Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA

    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA

    Duke Margolis Center for Health Policy, Duke University, Durham, NC, 27708, USA
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  • Kevin C. Oeffinger
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Medicine, Duke University Medical Center, Box 3893, Durham, NC, 27710, USA
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  • S. Yousuf Zafar
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA

    Duke Margolis Center for Health Policy, Duke University, Durham, NC, 27708, USA

    Department of Medicine, Duke University Medical Center, Box 3893, Durham, NC, 27710, USA

    Change Healthcare, 216 Centerview Dr #300, Nashville, TN, 37219, USA
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  • Author Footnotes
    7 Cancer Risk and Control Program, Sidney Kimmel Cancer Center at Thomas Jefferson University, 233 S 10th St, Philadelphia, PA 19107.
    Terry Hyslop
    Footnotes
    7 Cancer Risk and Control Program, Sidney Kimmel Cancer Center at Thomas Jefferson University, 233 S 10th St, Philadelphia, PA 19107.
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Biostatistics and Bioinformatics, Duke University Medical Center, Box 2717, Durham, NC, 27710, USA
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  • E. Shelley Hwang
    Affiliations
    Department of Surgery, Duke University Medical Center, Box 3513, Durham, NC, 27710, USA

    Duke Cancer Institute, Durham, NC, 27710, USA
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  • Steven R. Patierno
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Medicine, Duke University Medical Center, Box 3893, Durham, NC, 27710, USA
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  • Nadine J. Barrett
    Affiliations
    Duke Cancer Institute, Durham, NC, 27710, USA

    Department of Family Medicine and Community Health, Duke University Medical Center, Box 2914, Durham, NC, 27710, USA

    Duke Clinical and Translation Science Institute, Duke University School of Medicine, Durham, NC, 27710, USA
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  • Author Footnotes
    1 Division of Breast Surgery, Department of Surgery, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104.
    2 Rena Rowan Breast Center, Abramson Cancer Center, Philadelphia, PA 19104.
    3 Penn Center for Cancer Care Innovation (PC3I), The University of Pennsylvania, Philadelphia, PA 19104.
    4 Leonard Davis Institute of Health Economics (LDI), The University of Pennsylvania, Philadelphia, PA 19104.
    5 Division of Surgical Oncology, Department of Surgery, Yale University School of Medicine, New Haven, CT 06520.
    6 The Breast Center at Smilow Cancer Hospital at Yale New Haven, New Haven CT 06511.
    7 Cancer Risk and Control Program, Sidney Kimmel Cancer Center at Thomas Jefferson University, 233 S 10th St, Philadelphia, PA 19107.
Published:November 02, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.10.059

      Highlights

      • We conducted a community-based assessment of cancer screening in North Carolina.
      • 24 organizations at 47 events distributed a 91-item survey to >2000 adults.
      • Healthy diets were associated with greater breast & colorectal screening knowledge.
      • Negative attitudes about & barriers to care were associated with less screening.
      • Having a place to seek medical care predicted greater odds of colorectal screening.

      Abstract

      Background

      We sought to identify modifiable factors associated with cancer screening in a community-based health assessment.

      Methods

      24 organizations at 47 community events in central North Carolina distributed a 91-item survey from April–December 2017. Responses about (1) interest in disease prevention, (2) lifestyle choices (e.g., diet, tobacco), and (3) perceptions of primary care access/quality were abstracted to examine their association with self-reported screening participation and knowledge about breast, prostate, and colorectal cancer.

      Results

      2135/2315 participants (92%; 38.5% White, 38% Black, 9.9% Asian) completed screening questions. >70% of screen-eligible respondents reported guideline-concordant screening. Healthy dietary habits were associated with greater knowledge about breast and colorectal cancer screening; reporting negative attitudes about and barriers to healthcare were associated with less breast, prostate, and colorectal cancer screening. Having a place to seek medical care (a proxy for primary care access) was independently associated with being ∼5 times as likely to undergo colorectal screening (OR 4.66, 95% CI 1.58–13.79, all p < 0.05).

      Conclusions

      In this diverse, community-based sample, modifiable factors were associated with screening engagement, highlighting opportunities for behavioral intervention.

      Keywords

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