Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75)

Kevin M. Korous, Uchenna C. Ogbonnaya, Mary A. De Vera, Ellen Brooks, Justin X. Moore, Charles R. Rogers

Research output: Contribution to journalArticlepeer-review


Purpose: To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45–75 years. Methods: We recruited 492 self-identified males aged 45–75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can’t make ends meet, unmet material needs, and financial cutbacks . Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit. Results: Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (β = 0.47, 95% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (β = 0.22, 95% CI: 0.11, 0.34), but was not significantly associated with subjective norms (β = 0.07, 95% CI: − 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers. Conclusions: Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.

Original languageEnglish
Pages (from-to)737-747
Number of pages11
JournalCancer Causes and Control
Issue number9
StatePublished - Sep 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.


  • Early detection of cancer
  • Health behavior
  • Income
  • Men’s health
  • Socioeconomic factors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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