Investigating FIT kit completion for CRC screening in younger adults in rural areas

Rural regions have higher incidence rates of colorectal cancer (CRC) than urban regions, while screening is lower in rural residents than in urban residents. Rural residents experience barriers to CRC screening due to a lack of access to healthcare, perceived lack of privacy, and other cultural factors. The fecal immunochemical tests (FITs) may provide an inexpensive and convenient alternative for those lacking access to a colonoscopy or sigmoidoscopy. In a clinical trial, we investigated factors that influenced the return of a FIT kit for CRC screening among 1,230 rural residents in a midwestern U.S. state. Participants were selected from two cancer screening databases maintained by the state health department. Participants returning and not returning the FIT kit were compared for differences by age category (45–54, 55–64, 65–74), gender (female vs. male), race (non-white vs. white), and ethnicity (Hispanic vs. not Hispanic) using chi-square tests and logistic regression. Cox proportional hazard models and Kaplan–Meier curves were used to assess differences in FIT kit return time by age and gender. The youngest age group was significantly less likely to return the FIT kit and were slower at returning it when they did. In models adjusted for age category, females were significantly more likely to return the FIT kit than males and returned the FIT kit sooner than males. The results suggest that efforts are needed to reach those 45 to 55, especially males, who are not likely to see the need for CRC screening.