Determinants of home-based stool test kit use for colorectal cancer screening among older adults

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Early detection is widely known to result in a more favorable prognosis. This study examines the socio-demographic determinants of and geographic disparities in home-based stool test kit (screening recommended by United States Preventive Service Task Force (USPSTF)) use among older adults (50 to 75 years). BRFSS Texas (2004-2010) data was used to examine the determinants of and disparities in kit use. Uni-variate analyses indicated that race, educational attainment, employment status, marital status, and Income could predict the home-based stool test kit use. The use of kit varied across Texas public health service regions and by bordering and non-bordering counties. Multivariate analyses showed that higher age group (65-75 years) adults were almost twice more likely to report the of kit compared to lower age adults (OR=1.9). Hispanics and ‘other' were less likely to use kit compared to Whites (ORs, 0.6 and 0.46). Higher income adults were more likely to report the use of kit compared to low income individuals. College graduates were more than twice likely to report use of kit compared to those with less than high school education (OR=2.1). Employed adults were more likely to report the use of kit compared to unemployed ones (OR=1.55). Programs trying to increase the use of home-based stool test kit should focus on low-income, less educated, Hispanics and ‘other' and unemployed individuals. Texas can improve the overall CRC screening rates focusing on identified geographic areas.