Abstract
BACKGROUND: Colorectal cancer screening has been shown to be effective in reducing the burden of colorectal cancer. However, the screening rate has been suboptimal, and mortality due to colorectal cancer remains high. With the presence of proactive prevention strategies, low screening rates could still be due to individual factors. Following the health-belief model, this study examined the relationship between self-rated general health perception and colorectal cancer screening. METHODS: The study utilized the 2022 Behavioral Risk Factor Surveillance System (BRFSS) Annual Survey dataset. The sample size was 177,889 and included individuals aged 45-75 years. The outcome variable was a categorical variable with binary responses of screened or not screened. The main predictor variable was an ordinal variable with five responses of poor, fair, good, very good, and excellent in the assessment of self-rated general health. Other covariates were age, sex, marital status, race, insurance status, level of education, annual income, and poor physical and mental health durations. The weighting variable of the dataset was used to adjust the sample to a weighted sample size. After obtaining descriptive statistics, simple and multivariate logistic regressions were fitted to analyze the relationship between the main predictor and the outcome variables. Statistical significance was set at a 95% confidence level. RESULT: The weighted sample size was 83,303,438. Of these, 70.09% were screened and 29.91% were not screened for colorectal cancer. Excellent general health was reported by 14.80%, 34.32% very good, 32.1% good, 13.91% fair, and 4.87% had poor general health. Individuals with excellent general health perception were 25% less likely (adjusted odds ratio (AOR)=0.75; 95% CI=0.65, 0.88; p<0.0001) to be screened for colorectal cancer compared to those with poor general health perception. CONCLUSION: This study identifies the individual's excellent health perception as a possible contributing factor to the deficiency towards the realization of the goal in the rate of screening uptake and the need for revised and improved awareness programs.