Correlates of Community-Based Colorectal Cancer Screening in a Rural Population: The Role of Fatalism

Richard A. Crosby, Tom Collins

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Objective: One largely unexplored barrier to colorectal cancer (CRC) screening is fatalistic beliefs about cancer. The purpose of this study was to identify correlates of ever having endoscopy screenings for CRC and to determine whether fatalism plays a unique role. Because evidence suggests that cancer-associated fatalistic beliefs may be particularly common among rural Americans, the study was conducted in a medically underserved area of rural Appalachia. Methods: Rural residents (N = 260) between 51 and 75 years of age, from a medically underserved area of Appalachia, Kentucky, were recruited for a cross-sectional study. The outcome measure was assessed by a single item asking whether participants ever had a colonoscopy or flexible sigmoidoscopy. Demographic and health-related correlates of this outcome were selected based on past studies of rural populations. A single item assessed perceptions of fatalism regarding CRC. Age-adjusted analyses of correlates testing significant at the bivariate level were conducted. Results: The analytic sample was limited to 135 rural residents indicating they had ever had CRC endoscopy and 107 indicating never having endoscopy. In age-adjusted analyses, only the measure of fatalism had a significant association with having endoscopy. Those endorsing the statement pertaining to fatalism were 2.3 times more likely (95% CI = 1.24-4.27, P =.008) than the remainder to indicate never having endoscopy. Conclusions: A community-based approach to the promotion of endoscopy for CRC screening could focus on overcoming CRC-associated fatalism, thereby potentially bringing more unscreened people to endoscopy clinics.

Original languageEnglish
Pages (from-to)402-405
Number of pages4
JournalJournal of Rural Health
Issue number4
StatePublished - Sep 1 2017

Bibliographical note

Publisher Copyright:
© 2017 National Rural Health Association


  • cancer screening
  • colorectal cancer
  • fatalism
  • rural
  • social determinants of health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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