Gender differences in the use of colorectal cancer tests among older Chinese adults

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society 2013-10, Vol.17 (5), p.603-609
• Main Authors: Choi, Kai Chow, So, Winnie K.W, Chan, Dorothy N.S, Shiu, Ann T.Y, Ho, Simone S.M, Chan, Helen Y.L, Lam, Wendy W.T, Cheng, Karis K.F, Goggins, William B, Chan, Carman W.H
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Asian Continental Ancestry Group - statistics & numerical data; Attitude to Health - ethnology; Chinese; Colonoscopy; Colonoscopy - utilization; Colorectal cancer; Colorectal Neoplasms - prevention & control; Confidence Intervals; Cross-Sectional Studies; Cultural Characteristics; Doctors; Early Detection of Cancer - standards; Early Detection of Cancer - trends; Female; Gender difference; Gender differences; Genetic family histories; Health status; Hematology, Oncology and Palliative Medicine; Hong Kong; Humans; Male; Middle Aged; Nursing; Occult Blood; Odds Ratio; Perceptions; Risk Assessment; Screening behaviour; Sex Factors; Sigmoidoscopy - utilization; Sociodemographic aspects; Uptake
• ISSN: 1462-3889; 1532-2122
• DOI: 10.1016/j.ejon.2013.01.004

Abstract Purpose The study aimed to explore the gender difference in using colorectal cancer (CRC) tests among Chinese aged 50 years or over. Methods A cross-sectional study was conducted in 2004 Chinese older adults through anonymous telephone survey which covered socio-demographic variables, health status, use of complementary therapy, health-related perceptions and use of CRC tests. Results The uptake rate of flexible sigmoidoscopy (FS)/colonoscopy was 14% for males and 10% for females, with males significantly more likely to have had the test after adjusting for their differences in socio-demographics, health status, use of complementary therapies, health-related perceptions and recommendation received from health professionals (adjusted OR = 1.5, 95% CI: 1.1–2.0, p  = 0.005). The uptake of fecal occult blood test was nearly the same (19%) for both genders. Further interaction analyses indicates that the effect of a family history of cancer on the uptake of a FS/colonoscopy is significantly weaker in males than in females (the interaction odds ratio = 0.4, 95% CI: 0.2–0.8, p  = 0.011), whereas a male perceived that visiting a doctor is good for health will be more likely to have an uptake of a FS/colonoscopy than a female with such perception (the interaction odds ratio = 2.1, 95% CI: 1.1–3.8, p  = 0.018). Conclusions The uptake of CRC tests was low in this average-risk population. More effort is needed to educate the public about the importance and benefits of CRC tests. In view of the gender differences in some determinants of FS/colonoscopy uptake, particular attention should be given to develop gender-specific strategies to improve the rate.