Reported Barriers to Cancer Screening: Montana Behavioral Risk Factor Surveillance System 2007

Abstract

Purpose. To determine self-identified barriers to cancer screening participation in Montana among respondents to the Behavioral Risk Factor Surveillance System (BRFSS). Design. The 2007 BRFSS survey. Setting. State of Montana. Subjects. A total of 3433 respondents (2029 women) 50 years and older. Measures. Respondents who had never had an endoscopy and women who had not had a recent mammogram were asked why they had not been screened. Analysis. Associations between health care access variables and screening participation were assessed using X2 tests. Joint effects of multiple independent predictors of screening participation were assessed using odds ratios (ORs) and 95% confidence intervals (CIs) from multiple logistic regression analysis. Results. The strongest predictor of having an endoscopy (OR, 23.62; 95% CI, 18.42-30.28) or recent mammogram (OR, 10.87; 95%, CI, 6.42-18.40) was provider recommendation. The most common reasons for not being screened were respondent's belief that it was not necessary (44% for endoscopy and 39% for mammography), no provider recommendation (22% for endoscopy), and cost (12% for endoscopy and 19% for mammography). Among unscreened respondents whose providers recommended endoscopy and mammography, 30% and 36%, respectively, believed that it was not necessary. Conclusions. Many Montanans remain unaware of the importance of cancer screening. Health care providers and public health officials must increase patient education, and providers must continue to refer patients for screening.