Predictors of colorectal cancer testing using the California Health Inventory Survey

Table 1 Characteristics of California Health Inventory Survey participants ages 50-80 years (bootstrap 95%CI)

	Totaln = 10  596  208	Colonoscopy/Flexible sigmoidoscopy/Fecal occult blood testn = 6  678  773	Colonoscopyn = 4  711  189	No colonoscopy/Flexible sigmoidoscopy/Fecal occult blood testn = 3  917  435
Mean age, yr	63.33 (63.32-63.33)	64.19 (64.18-64.20)	64.69 (64.68-64.70)	61.86 (61.85-61.87)
Males, %	46.6 (46.5-46.6)	46.8 (46.7-46.8)	47.2 (47.1-47.2)	46.3 (46.2-46.3)
Body mass index, kg/m2, %
< 18.5	1.7 (1.6-1.7)	1.5 (1.5-1.5)	1.5 (1.5-1.6)	2.0 (1.9-2.0)
18.5-24.99	36.1 (36.0-36.1)	35.1 (35.0-35.1)	36.3 (36.3-36.4)	37.8 (37.8-37.9)
25.0-29.99	37.2 (37.1-37.2)	38.6 (38.6-38.7)	37.8 (37.8-37.9)	34.7 (34.7-34.8)
> 30.0	25.1 (25.1-25.1)	24.8 (24.8-24.9)	24.3 (24.3-24.3)	25.5 (25.5-25.6)
Ethnicity1, %
White	60.8 (60.8-60.9)	63.7 (63.7-63.8)	66.1 (66.1-66.2)	55.9 (55.8-56.0)
African American	6.1 (6.1-6.1)	6.3 (6.3-6.3)	6.0 (6.0-6.0)	5.8 (5.8-5.8)
Latino	14.8 (14.8-14.9)	12.2 (12.2-12.3)	10.6 (10.6-10.7)	19.2 (19.2-19.3)
Asian	11.3 (11.2-11.3)	10.7 (10.7-10.7)	10.5 (10.4-10.5)	12.2 (12.2-12.2)
Other	7.0 (7.0-7.0)	7.0 (7.0-7.0)	6.7 (6.6-6.7)	5.8 (5.7-5.8)
Smoking status, %
Current	11.1 (11.1-11.2)	8.2 (8.2-8.3)	8.0 (8.0-8.0)	16.1 (16.1-16.1)
Former	35.9 (35.8-35.9)	37.8 (37.8-37.9)	38.4 (38.3-38.4)	32.5 (32.5-32.6)
Never	53.0 (52.9-53.0)	53.9 (53.9-54.0)	53.6 (53.6-53.7)	51.3 (51.3-51.4)
Did not complete high school, %	15.7 (15.7-15.8)	12.9 (12.9-13.0)	10.7 (10.7-10.8)	20.4 (20.4-20.5)
Marital status, %
Married	65.0 (65.0-65.0)	67.9 (67.8-67.9)	68.8 (68.7-68.8)	60.1 (60.0-60.1)
Living w/partner	4.1 (4.1-4.1)	3.7 (3.7-3.8)	3.6 (3.6-3.6)	4.6 (4.6-4.7)
Widow/separated/divorced	25.1 (25.1-25.2)	23.7 (23.6-23.7)	23.2 (23.2-23.2)	27.7 (27.6-27.7)
Never married	5.8 (5.8-5.8)	4.7 (4.7-4.7)	4.4 (4.4-4.4)	7.6 (7.6-7.7)
Household income (United States $)	73  671 (73  630-73  720)	79  191 (79  151-79  238)	81  798 (81  728-81 876)	64  260 (64  157-64  336)
Income relative to poverty level, %
0-99	10.8 (10.8-10.8)	7.7 (7.7-7.8)	7.1 (7.1-7.1)	16.5 (16.4-16.5)
100-199	17.1 (17.1-17.2)	14.9 (14.8-14.9)	14.3 (14.3-14.3)	21.3 (21.2-21.3)
200-299	13.7 (13.6-13.7)	13.2 (13.2-13.3)	13.5 (13.5-13.5)	14.4 (14.4-14.5)
> 300	58.4 (58.4-58.4)	64.2 (64.1-64.2)	65.1 (65.1-65.2)	47.8 (47.6-47.9)
Dwelling2, %
Urban	39.7 (39.6-39.7)	39.5 (39.4-39.5)	37.6 (37.6-37.7)	40 (40.0-40.1)
Secondary city	20.3 (20.2-20.3)	19.5 (19.5-19.6)	19.4 (19.3-19.4)	21.4 (21.4-21.5)
Suburban	25.1 (25.1-25.1)	26.9 (26.9-27.0)	28.2 (28.2-28.3)	22.1 (22.0-22.1)
Rural	15.0 (14.9-15.0)	14.1 (14.0-14.1)	14.8 (14.8-14.8)	16.4 (16.4-16.5)
Insurance status, %
Uninsured	9.5 (9.5-9.5)	4.6 (4.6-4.6)	3.3 (3.3-3.3)	17.8 (17.8-17.9)
Medicare and medicaid	8.9 (8.9-9.0)	8.0 (8.0-8.0)	8.5 (8.5-8.6)	10.5 (10.5-10.5)
Medicare and others	27.2 (27.2-27.2)	31.8 (31.8-31.9)	33.9 (33.9-34.0)	19.3 (19.3-19.4)
Medicare only	3.4 (3.4-3.4)	3.1 (3.1-3.1)	3.4 (3.4-3.4)	3.8 (3.8-3.8)
Medicaid	3.6 (3.6-3.6)	2.3 (2.3-2.3)	2.1 (2.0-2.1)	5.8 (5.7-5.8)
Employer-based	41.1 (41.0-41.1)	43.6 (43.6-43.6)	42.2 (42.1-42.2)	36.7 (36.7-36.7)
Privately purchased	4.6 (4.6-4.6)	4.6 (4.6-4.6)	4.6 (4.6-4.6)	4.6 (4.5-4.6)
Other	1.8 (1.8-1.8)	2.0 (2.0-2.0)	2.1 (2.0-2.1)	1.5 (1.5-1.5)
Alcohol use, %
Never	93.3 (93.2-93.4)	93.5 (93.4-93.6)	93.5 (93.4-93.6)	93.0 (93.0-93.1)
Yes	6.7 (6.2-6.8)	6.6 (6.5-6.9)	6.5 (6.5-6.8)	6.9 (6.8-7.0)
Working status, %
Employed full time	41.4 (41.4-41.4)	39.9 (39.8-39.9)	38.1 (38.1-38.2)	44.0 (43.9-44.0)
Employed part time	7.1 (7.1-7.1)	7.0 (7.0-7.1)	7.2 (7.2-7.2)	7.1 (7.1-7.2)
Mod-Severe work impaired	6.1 (6.1-6.1)	5.4 (5.4-5.4)	5.3 (5.3-5.4)	7.4 (7.4-7.5)
Spouse Employed F/P Time	32.6 (32.4-32.6)	33.6 (33.5-33.6)	33.4 (33.4-33.6)	30.8 (30.7-30.8)

¹UCLA CHPR Definition;

² By census tract.

Table 2 Health screening issues and compliance as related to receiving a colonoscopy for California Health Inventory Survey participants ≥ 50 years old (bootstrap 95%CI)

	Colonoscopyn = 4  711  189	No colonoscopyn = 5  885  019
Number doctor visits in past year, %	4.22 (4.22-4.22)	3.28 (3.28-3.28)
Site of health provider, %
Doctor’s office	78.1 (78.1-78.2)	65.1 (65.0-65.1)
Community/government clinic	18.1 (18.1-18.2)	21.4 (21.3-21.4)
Emergency room	0.2 (0.2-0.2)	0.8 (0.8-0.8)
Random source/none	0.5 (0.5-0.5)	12.7 (12.6-12.7)
General health, %
Excellent	17.8 (17.7-17.7)	16.7 (16.6-16.7)
Very good	31.0 (31.0-31.1)	28.2 (28.2-28.3)
Good	29.0 (28.9-29.1)	29.0 (28.9-29.0)
Fair	16.3 (16.3-16.4)	19.2 (19.2-19.3)
Poor	5.8 (5.8-5.8)	6.9 (6.9-6.9)
Medical health, %
Elevated cholesterol	12.1 (12.1-12.2)	10.0 (9.9-10.0)
Hypertension	43.8 (43.8-43.9)	35.9 (35.8-35.9)
Diabetes	15.9 (15.9-15.9)	15.0 (14.9-15.0)
Heart disease	14.2 (14.1-14.2)	10.8 (10.8-10.8)
Mammograms in past 6 yr, n	2.23 (2.23-2.34)	1.64 (1.63-1.64)
PSA ever tested, %	34.3 (34.3-34.4)	22.1 (22.0-22.1)
Physician recommended “colon test”, %	67.3 (67.3-67.4)	39.6 (39.5-39.6)
Reason for colonoscopy, %
Routine screening	75.4 (75.3-75.4)
Because of a problem	16.8 (16.7-16.8)
Other	7.9 (7.9-7.9)
Reason no colonoscopy in 10 yr, %
Never thought about it		11.9 (11.9-12.0)
Doctor did not recommend		10.0 (10.0-10.1)
No problems/not necessary		9.6 (9.5-9.6)
Too expensive/no insurance		4.5 (4.5-4.6)
Procrastination		3.8 (3.8-3.8)
Too painful/embarrassing		2.9 (2.9-2.9)
Other		57.3 (57.3-57.4)
Family history of CRC, %
Sibling	2.8 (2.8-2.8)	1.6 (1.6-1.6)
Father	4.1 (4.1-4.1)	1.8 (1.8-1.8)
Mother	3.8 (3.8-3.8)	1.4 (1.4-1.4)
Total	10.7 (10.7-10.7)	4.8 (4.8-4.8)

CRC: Colorectal cancer; PSA: Prostate specific antigen.

Table 3 Language and demographic characteristics of Latino/Hispanic California Health Inventory Survey Participants ages 50-80 years related to colon cancer screening status (bootstrap 95%CI)

	Total	Colonoscopy/Flexible sigmoidoscopy/Fecal occult blood test	Colonoscopy	No Colonoscopy/Flexible sigmoidoscopy/Fecal occult blood test
	Weighted	Weighted	Weighted	Weighted
	n = 1  487  447	n = 801  832	n = 492  646	n = 685  615
Latino/Hispanic sub-type, %
Mexican	80.6 (80.5-80.6)	79.8 (79.7-79.9)	79.2 (79.1-79.4)	81.4 (81.3-81.5)
Salvadoran	8.2 (8.1-8.2)	6.4 (6.4-6.5)	8.0 (7.9-8.1)	10.3 (10.3-10.4)
Guatemalan	2.4 (2.3-2.4)	2.0 (2.0-2.0)	1.6 (1.6-1.7)	2.7 (2.7-2.8)
Central American	2.8 (2.7-2.8)	3.5 (3.4-3.5)	3.0 (2.9-3.0)	1.9 (1.9-1.9)
South American	2.1 (2.0-2.1)	2.7 (2.7-2.8)	2.3 (2.3-2.3)	1.4 (1.3-1.4)
Other Latino	3.9 (3.8-3.9)	5.6 (5.5-5.6)	5.9 (5.9-6.0)	2.3 (2.3-2.4)
Citizen status, %
United states born citizen	31.2 (31.1-31.2)	37.1 (37.0-37.2)	39.3 (39.1-39.4)	24.2 (24.1-24.3)
Naturalized citizen	43.5 (43.4-43.6)	47.4 (47.3-47.6)	50.2 (50.1-50.3)	38.9 (38.8-39.0)
Non-citizen	25.3 (25.2-25.4)	15.4 (15.4-15.5)	10.5 (10.4-10.6)	36.9 (36.8-37.0)
Year lived in United States, %
≤ 1	0.2 (0.2-0.2)	0.0 (0.0-0.1)	0.0 (0.0-0.2)	0.5 (0.4-0.5)
2-4	1.4 (1.3-1.4)	1.1 (1.1-1.1)	0.8 (0.8-0.8)	1.6 (1.6-1.7)
5-9	1.0 (1.0-1.1)	0.5 (0.5-0.5)	0.3 (0.2-0.3)	1.6 (1.6-1.7)
10-14	3.9 (3.8-3.9)	3.1 (3.1-3.2)	1.3 (1.2-1.3)	4.8 (4.7-4.8)
≥ 15	62.4 (62.3-62.4)	58.1 (58.1-58.3)	58.4 (58.3-58.6)	67.3 (67.2-67.5)
Not ascertained	31.2 (31.2-31.3)	37.2 (37.2-37.3)	39.2 (39.1-39.4)	24.2 (24.1-24.5)
Ability to speak English, %
Very good	13.0 (12.9-13.1)	15.5 (15.4-15.5)	17.7 (16.9-17.1)	10.1 (10.1-10.2)
Good	19.1 (19.0-19.1)	21.7 (21.6-21.8)	26.9 (26.7-27.0)	16.1 (16.0-16.2)
Not good	33.4 (33.3-33.5)	29.6 (29.5-29.8)	23.1 (23.0-23.3)	37.8 (37.7-37.9)
Not at all	18.8 (18.7-18.8)	14.6 (14.5-14.7)	15.3 (15.2-15.)	23.6 (23.5-23.7)
Language of TV/radio/newspaper, %
English	17.2 (17.1-17.3)	19.9 (19.8-20.0)	24.3 (24.2-24.5)	14.0 (14.0-14.2)
English and Spanish	33.0 (32.9-33.1)	32.9 (32.7-33.0)	31.1 (30.9-31.2)	33.2 (33.1-33.3)
Only Spanish	34.1 (34.0-34.2)	28.7 (28.6-28.8)	27.6 (27.5-27.8)	40.4 (40.3-40.6)
Not ascertained	15.7 (15.7-15.7)	18.6 (18.5-18.7)	17.0 (16.9-17.1)	12.3 (12.2-12.4)
Language spoken at home, %
English	15.7 (15.7-15.8)	18.6 (18.5-18.7)	17.0 (16.9-17.1)	12.3 (12.2-12.4)
English and Spanish	46.6 (46.5-46.7)	48.4 (48.3-48.5)	54.0 (53.9-54.3)	44.5 (44.4-44.7)
Only Spanish	37.0 (36.9-37.1)	32.2 (32.2-32.3)	28.1 (27.9-28.2)	42.6 (42.5-42.8)
Other	0.7 (0.7-0.7)	0.8 (0.8-0.9)	0.9 (0.8-0.9)	0.6 (0.6-0.7)
Doctor conducted last interview in, %
English	32.0 (31.9-32.1)	41.0 (40.8-41.1)	46.4 (46.2-46.5)	21.5 (21.4-21.6)
Spanish	39.7 (39.6-39.8)	34.5 (34.4-34.6)	29.6 (29.4-29.7)	45.7 (45.6-45.9)
Not ascertained	28.3 (28.2-28.4)	24.5 (24.4-24.6)	24.0 (23.9-24.3)	32.8 (32.7-32.9)
Hard time understanding your doctor, %
Yes	5.3 (5.2-5.3)	3.5 (3.5-3.6)	4.0 (3.9-4.1)	7.3 (7.2-7.4)
No	87.0 (87.0-87.1)	94.1 (94.0-94.2)	92.4 (92.3-92.5)	78.8 (78.7-78.9)
Not ascertained	7.7 (7.7-7.8)	2.4 (2.2-2.6)	3.6 (3.5-3.7)	13.9 (13.8-14.0)

Table 4 Multivariable logistic regression (dependent variable is colon cancer test in previous 5 years)

Variable	n	All participants adjustedOR1 (95%CI)	White adjustedOR1 (95%CI)	Black adjustedOR1 (95%CI)	Hispanic adjustedOR1 (95%CI)
Gender
Female	5 658 375	1.00	1.00	1.00	1.00
Male	4 937 833	1.06 (1.06-1.06)	1.03 (1.03-1.04)	1.07 (1.06-1.08)	1.25 (1.24-1.26)
High school educated
No	1 663 605	1.00	1.00	1.00	1.00
Yes	8 932 603	1.01 (1.00-1.01)	0.96 (0.95-0.99)	1.03 (0.98-1.05)	1.28 (1.27-1.29)
Family history of colon cancer
No	9 809 630	1.00	1.00	1.00	1.00
Yes	786 578	1.71 (1.70-1.72)	1.88 (1.87-1.89)	1.54 (1.53-1.56)	1.29 (1.26-1.33)
Income relative to poverty level
0%-99%	1 144 390	1.00	1.00	1.00	1.00
100%-199%	1 811 952	1.21 (1.20-1.21)	1.33 (1.30-1.36)	1.14 (1.12-1.15)	0.88 (0.87-0.89)
200%-299%	1 451 680	1.41 (1.40-1.42)	1.44 (1.40-1.48)	1.31 (1.27-1.40)	1.50 (1.49-1.52)
> 300%	6 188 185	1.69 (1.68-1.70)	1.77 (1.72-1.86)	1.66 (1.64-1.69)	1.48 (1.46-1.50)
Health insured
No	1 006 640	1.00	1.00	1.00	1.00
Yes	9 589 568	2.71 (2.70-2.72)	2.88 (2.87-2.89)	2.14 (2.11-2.23)	3.52 (3.48-3.56)
Physician Recommended colon test
No	5 095 110	1.00	1.00	1.00	1.00
Yes	5 501 098	3.90 (3.88-3.91)	3.77 (3.74-3.80)	3.99 (3.96-4.02)	4.37 (4.32-4.42)
Citizenship status1
United States born citizen	464 083				1.00
Naturalized citizen	647 039				1.91 (1.89-1.93)
Years lived in United States1
≤ 1	29 749				1.00
2-4	20 824				0.98 (0.96-1.02)
5-9	14 874				1.38 (1.33-1.44)
10-14	58 010				0.78 (0.75-0.82)
≥ 15	928 167				1.57 (1.54-1.62)
Hard time understanding physician1
Yes	78 835				1.00
No	1 294 079				2.44 (2.40-2.48)

¹Numbers for Hispanic/Latino only. OR: Odds ratio.