• Pamela M Marcus, Sheryl L Ogden, Lisa H Gren, Jeffery C Childs, Shannon M Pretzel, Lois E Lamerato, Kayo Walsh, Heather M Rozjabek, Jerome Mabie, Brett Thomas, and Tom Riley.
• National Cancer Institute, Division of Cancer Control and Population Sciences, 9609 Medical Center Dr, Room 4E-608, Bethesda, MD 20892-9763, USA. Electronic address: marcusp@mail.nih.gov.
• Prev Med. 2014 Oct 1; 67: 828882-8.

ObjectiveIdentify predictors of non-compliance with first round screening exams in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.MethodThe PLCO was conducted from 1993 to 2011 at 10 US institutions. A total of 154,897 healthy men and women ages 55-74 years were randomized. Intervention arm participants were invited to receive gender-appropriate screening exams for prostate, lung, colorectal and ovarian cancer. Using intervention-arm data (73,036 participants), non-compliance percentages for 13 covariates were calculated, as were unadjusted and adjusted odds ratios (ORs), and 95% confidence intervals. Covariates included demographic factors as well as factors specific to PLCO (e.g., method of consent, distance from screening center).ResultsThe rate of non-compliance was 11% overall but varied by screening center. Significant associations were observed for most covariates but indicated modest increases or decreases in odds. An exception was the use of a two-step consent process (consented intervention arm participants for exams after randomization) relative to a one-step process (consented all participants prior to randomization) (OR: 2.2, 95% CI: 2.0-2.5). Non-compliance percentages increased with further distance from screening centers, but ORs were not significantly different from 1.ConclusionsMany factors modestly influenced compliance. Consent process was the strongest predictor of compliance.Published by Elsevier Inc.

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