Perceptions of risk factors for colorectal cancer and colorectal cancer risk-related behaviors among current, ex-, and nonsmokers

Smoking significantly increases risk for colorectal cancer (CRC). We examined smokers' and nonsmokers' perceptions of behavioral factors for the increased risk of CRC and evaluated how these related to CRC screening. Self-reported questionnaire data were obtained from a random, average CRC risk sample of women and men (aged 50-75 years) during 2004. Smokers less frequently reported recent CRC screening than nonsmokers (p=0.03). Smokers not adherent to screening less frequently agreed that smoking and alcohol consumption (both strongly linked to CRC) increased the risk for CRC (p values<0.05) than nonsmokers. Notably, the number of concurrent CRC risk behaviors reported by smokers not adherent to CRC screening increased with the number of cigarettes smoked per day, identifying heavy smokers who do not screen as a subgroup most in need of intervention. Findings extend current understanding on processes underlying smokers' perceptions of risk for CRC and how these relate to screening utilization, which can guide provider efforts to improve CRC screening among smokers and reduce their CRC risk-related behaviors.