Introduction: Background: It is well known that a family history of colorectal cancer (CRC) is associated with an increased risk of the disease. However, it is uncertain if knowledge of family cancer history influences CRC screening uptake independent of formal educational attainment.
Aim: To evaluate the role of knowledge of family cancer history and educational attainment on CRC screening among adults in the United States.
Methods: Methods: We used the 2018 Health information National Trends Survey (HINTS) 5 cycle 2. We identified 2,276 respondents (weighted population size = 132, 125, 477) who gave information regarding their highest formal educational attainment, knowledge of their family cancer history and whether they have been screened for CRC. We used survey weights in all analyses to obtain national estimates and used logistic regression analyses to calculate odds ratios (OR) and 95% confidence intervals (CI). Our fully adjusted model included age, sex, race, BMI, smoking, marital status, and health insurance.
Results: Results: A total of 644 (33.8%) respondents had high school education or less, 715 (40.4%) had some college / vocation school education while 917 (25.8%) were college graduates. Overall, 1,494 (64.1%) respondents reported that they knew their family cancer history well. Respondents with college degrees were more likely to know their family cancer history (74.2%) versus 64.8% among those with some college / vocational training versus 55.5% among those with high school education or less (P value for trend < 0.001).
By education status, college graduates were more likely to have been screened for CRC (72.9%; OR=2.27; 95% CI: 1.40-3.68) as compared to 62%; OR= 1.13; 95% CI: 0.71-1.81) among those with some college or vocational training when compared to 59.7% among those with high school education or less (P value for trend = 0.017) regardless of knowledge of family cancer history. Overall, 1,494 (64.1%) respondents reported that they knew their family cancer history well and were more likely to have been screened for CRC (66.9% versus 58.9%; OR = 1.48; 95% CI: 1.04-2.10). However, formal education had more influence on CRC screening than knowledge of family cancer history (Table 1).
Discussion: Conclusion: Formal educational attainment significantly influences CRC screening uptake. However, acquisition of the knowledge of family cancer history should be encouraged among the population.
