Initial and Continued Adherence With Bladder Cancer Screening in an Occupationally Exposed Cohort

Objective: To identify significant predictors of initial and repeated adherence with bladder cancer screening in a high-risk occupationally exposed cohort. Methods: We analyzed longitudinal (13 years) health survey data and a cross-sectional behavioral health survey from the Drake Health Registry Study. Construct validity of the behavioral health survey scales was evaluated using factor analysis. Initial compliance and repeated adherence were examined in separate logistic regression models. Results: "Barriers to screening" and "social influence" were associated with initial participation. Lower or no alcohol consumption, comorbidities, worry that screening would find bladder cancer, and ease of arranging schedules were associated with continued adherence. Conclusions: Factors affecting adherence with bladder cancer screening change for initial participation and for continued adherence. To enhance overall adherence, specific strategies should be implemented when initiating a screening program and revised accordingly over time.