Characterizing the Perceived Need for CRC Screening among the Elderly Living in Rural Areas in the Pacific Northwest US: Roles of Miscommunication, Experience of Discrimination, and Dependence

Abstract

Purpose Increasing the perceived need for CRC screening can facilitate undertaking CRC screening. This study aims to identify factors associated with the need for CRC screening in rural populations. Design A cross-sectional online survey. Setting The survey was conducted in June - September 2022 in the rural areas of Alaska, Idaho, Oregon, and Washington, US. Subjects The subjects of this study were 250 adults (completion rate: 65%) aged 45-75 residing in rural Alaska, Idaho, Oregon, and Washington. Measures Perceived need for CRC screening, internet usage for health purposes, demographics, and intrapersonal, interpersonal, community, and environmental characteristics. Results Perceived need for CRC screening were negatively associated with patient-provider miscommunication ( β = −.23, P < .001) and perceived discrimination ( β = −.21, P < .001), cancer fatalism (β = −.16, P < .05), individualism ( β = −.15, P < .05), and dependence on community ( β = −.11, P < .05), but positively with compliance with social norms ( β = .16, P < .05), trust in health care providers ( β = .16, P < .05), knowledge about colorectal cancer ( β = .12, P < .05). Conclusions Our study showed potential individual and situational characteristics that might help increase colorectal cancer screening. Future efforts might consider addressing discrimination in health care settings, improving patient-provider communication, and tailoring messaging to reflect the rural culture.