Predictors of colorectal cancer screening behaviors among average-risk older adults in the United States.

Objective: To critically evaluate recent studies that examined determinants of CRC screening behaviors among average-risk older adults (>or=50 years) in the United States.

Methods: A PUBMED (1996-2006) search was conducted to identify recent articles that focused on predictors of CRC initiation and adherence to screening guidelines among average-risk older adults in the United States.

Results: Frequently reported predictors of CRC screening behaviors include older age, male gender, marriage, higher education, higher income, White race, non-Hispanic ethnicity, smoking history, presence of chronic diseases, family history of CRC, usual source of care, physician recommendation, utilization of other preventive health services, and health insurance coverage. Psychosocial predictors of CRC screening adherence are mostly constructs from the Health Belief Model, the most prominent of which are perceived barriers to CRC screening.

Conclusions: Evidence suggests that CRC screening is a complex behavior with multiple influences including personal characteristics, health insurance coverage, and physician-patient communication. Health promotion activities should target both patients and physicians, while focusing on increasing awareness of and accessibility to CRC screening tests among average-risk older adults in the United States.