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Classification tree analysis to examine influences on colorectal cancer screening

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Abstract

Purpose

Identifying correlates of colorectal cancer screening (CRCS) is critical for cancer control and prevention. Classification tree analysis (CTA) is a potentially powerful analytic tool that can identify distinct population subgroups for which CRCS is influenced by any number of multivariable interactions. This study used CTA to identify correlates of CRCS for exclusive population subgroups.

Methods

Data were obtained from the 2007 Health Information National Trends Survey (HINTS) and analyzed in 2014. CTA was employed to determine the association between demographic (n = 11), psychosocial (n = 6), and numeracy (n = 3) variables and CRCS status of adults ≥50 years (n = 3,769).

Results

Overall CRCS rate was 66.9 %. Level of doctor avoidance (three categories) was the initial splitting variable, leading to a total of 21 terminal node subgroups of CRCS utilization: (1) avoid doctor, not for fear of illness/death [n = 625 (16.5 %), four subgroups]; (2) avoid doctor, fear illness/death [n = 366 (9.7 %), two subgroups]; (3) do not avoid doctor [n = 2,778 (73.7 %), 15 subgroups].

Conclusions

Doctor avoidance was an important behavioral influence on CRCS adherence. Use of CTA to identify unique characteristics within population subgroups has merit for tailoring future intervention strategies. Community-based approaches may be effective for reaching individuals who avoid routine doctor visits.

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Acknowledgments

This research was internally supported by the University of Delaware.

Conflict of interest

The authors declare no conflict of interests.

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Authors and Affiliations

  1. Department of Behavioral Health and Nutrition, University of Delaware, 26 North College Avenue, Newark, DE, 19716, USA

    Gregory M. Dominick & Mia A. Papas

  2. Center for Population Health and Clinical Epidemiology, Brown University School of Public Health, Providence, RI, 02912, USA

    Michelle L. Rogers

  3. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02912, USA

    William Rakowski

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  1. Gregory M. Dominick
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  2. Mia A. Papas
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  4. William Rakowski
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Correspondence to Gregory M. Dominick.

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Dominick, G.M., Papas, M.A., Rogers, M.L. et al. Classification tree analysis to examine influences on colorectal cancer screening. Cancer Causes Control 26, 443–454 (2015). https://doi.org/10.1007/s10552-015-0523-6

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