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Initial and Continued Adherence With Bladder Cancer Screening in an Occupationally Exposed Cohort

Cassidy, Laura D. PhD, MS; Marsh, Gary M. PhD; Talbott, Evelyn O. DrPH, MPH; Kelsey, Sheryl F. PhD

Journal of Occupational and Environmental Medicine: April 2011 - Volume 53 - Issue 4 - p 455–460
doi: 10.1097/JOM.0b013e3182135841
Original Articles

Objective: To identify significant predictors of initial and repeated adherence with bladder cancer screening in a high-risk occupationally exposed cohort.

Methods: We analyzed longitudinal (13 years) health survey data and a cross-sectional behavioral health survey from the Drake Health Registry Study. Construct validity of the behavioral health survey scales was evaluated using factor analysis. Initial compliance and repeated adherence were examined in separate logistic regression models.

Results: “Barriers to screening” and “social influence” were associated with initial participation. Lower or no alcohol consumption, comorbidities, worry that screening would find bladder cancer, and ease of arranging schedules were associated with continued adherence.

Conclusions: Factors affecting adherence with bladder cancer screening change for initial participation and for continued adherence. To enhance overall adherence, specific strategies should be implemented when initiating a screening program and revised accordingly over time.

From the Medical College of Wisconsin (Dr Cassidy), Milwaukee, Wis; Center for Occupational Biostatistics and Epidemiology (Dr Marsh), Department of Biostatistics, and Department of Epidemiology (Drs Talbott and Kelsey) Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa.

Address correspondence to: Laura D. Cassidy, PhD, MS, Department of Surgery, 999 N 92nd Street, Children's Corporate Center, Suite C460, Wauwatosa, WI 53226; E-mail:

Funding provided by NIOSH, ATSDR, and the Pennsylvania Cancer Control Program.

This study was approved by the institutional review board of the University of Pittsburgh.

©2011The American College of Occupational and Environmental Medicine