Are symptoms of anxiety and depression associated with colorectal screening perceptions and behaviors among older adults in primary care?

Despite the existence of colorectal cancer (CRC) screening guidelines, population-based studies have consistently shown under-utilization of CRC screening procedures among older adults in the United States. We examined whether symptoms of anxiety and depression are associated with colorectal cancer (CRC) screening perceptions and behaviors among older adults in a primary care setting. A cross-sectional study was conducted by using a sample of 143 family medicine patients who completed an 88-item anonymous self-administered questionnaire covering symptoms of anxiety and depression as well as CRC screening perceptions (defined based on the Health Belief Model) and behaviors (defined as ever use of or adherence to CRC testing). Moderate-to-clinically significant anxiety and depressive symptoms were, respectively, prevalent in 47% and 42% of participants. Perceived benefits and barriers were the only Health Belief Model constructs associated with anxiety. Perceived barriers were positively associated with anxiety symptoms after adjustment for confounders, including age, gender, race/ ethnicity, marital status, education, smoking history, body mass index and self-rated health. By contrast, perceived benefits were negatively associated with anxiety symptoms only in the unadjusted model. Neither anxiety nor depression was associated with ever use of or adherence to CRC testing. Symptoms of anxiety, but not depression, may potentially influence CRC screening perceptions, with implications for behavioral interventions targeting CRC testing.