Correlates of Colorectal Cancer Screening among Hispanics: Results from the 2008 Puerto Rico Behavioral Risk Factor Surveillance System Survey

Objective: Colorectal cancer (CRC) is the second most commonly diagnosed cancer in Puerto Rico (PR). Given the lack of information on cancer screening behavior, we identified factors associated with CRC screening among adults aged >= 50 years in PR. Methods: Age-eligible adults who participated in the PR-Behavioral Risk Factor Surveillance System (BRFSS) in 2008 were included in the analysis (n=2,920). Weighted prevalence of fecal occult blood test (FOBT) within two years and of Sigmoidoscopy/Colonoscopy examination within five years before the interview were estimated, and logistic regression models were used to assess factors associated with these CRC screening practices. Results: Overall, 8.2% (95% CI 7.1%-9.3%) of the participants had had the FOBT within the past two years, 39.8% (95% CI 37.7%-41.9%) had sigmoidoscopy/colonoscopy examination within 5 years, and 46.7% (95% CI=44.5%-48.8%) had ever had any type of CRC screening. Factors positively associated to CRC screening in multivariable analyses included older age, higher education, and having had a routine check-up in the past year. Gender, body mass index, and other relevant covariates evaluated were not associated to screening behavior. Conclusion: Prevalence of CRC screening in PR during 2008 was below the goals established by Healthy People 2010 (50.0%) and 2020 (70.5%). We provide the first population-based estimates of CRC screening prevalence and correlates in a US predominantly Hispanic population. Low adherence to CRC screening may result in late stage at diagnosis and poorer disease outcomes. Public health efforts should focus on the promotion of CRC screening and early detection.