Repeat participation in colorectal cancer screening utilizing fecal occult blood testing: a community-based project in a rural setting.

BACKGROUND AND AIM: To investigate participation in a second round of colorectal cancer screening using a fecal occult blood test (FOBT) in an Australian rural community, and to assess the demographic characteristics and individual perspectives associated with repeat screening. METHODS: Potential participants from round 1 (50-74 years of age) were sent an intervention package and asked to return a completed FOBT (n = 3406). Doctors of participants testing positive referred to colonoscopy as appropriate. Following screening, 119 participants completed qualitative telephone interviews. Multivariable logistic regression models evaluated the association between round-2 participation and other variables. RESULTS: Round-2 participation was 34.7%; the strongest predictor was participation in round 1. Repeat participants were more likely to be female; inconsistent screeners were more likely to be younger (aged 50-59 years). The proportion of positive FOBT was 12.7%, that of colonoscopy compliance was 98.6%, and the positive predictive value for cancer or adenoma of advanced pathology was 23.9%. Reasons for participation included testing as a precautionary measure or having family history/friends with colorectal cancer; reasons for non-participation included apathy or doctors' advice against screening. CONCLUSION: Participation was relatively low and consistent across rounds. Unless suitable strategies are identified to overcome behavioral trends and/or to screen out ineligible participants, little change in overall participation rates can be expected across rounds.

Visual impairment and postural sway among older adults with glaucoma.

PURPOSE: To investigate the effect of visual impairment on postural sway among older adults with open-angle glaucoma. METHODS: This study included 54 community-dwelling participants with open-angle glaucoma, aged 65 and older. Binocular visual field loss was estimated from merged monocular Humphrey Field Analyzer visual field results and retinal nerve fiber layer (RNFL) thickness was obtained from the Stratus Optical Coherence Tomographer. Postural sway was measured under four conditions: eyes open and closed, on a firm, and a foam surface. Data were collected for additional vision measures (visual acuity and contrast sensitivity), physical performance measures (self-reported physical activity levels and 6-min walk test), and demographic measures (age, gender, body mass index, and medical history). Multivariate linear regressions, adjusting for confounding factors, were performed to determine the association between visual loss and postural sway. RESULTS: Participants with greater binocular visual field loss or thinner RNFL thickness showed increased postural sway, both on firm and foam surfaces, independent of age, gender, body mass index, and physical performance levels. These visual loss measures were significant predictors of postural sway, explaining almost 20% of its variance on the foam surface. Furthermore, participants with greater inferior hemifield visual field loss showed increased postural sway on the foam surface. Increasing glaucomatous visual impairment was accompanied by a steady decrease of the visual contribution to postural control. CONCLUSION: Among older adults with glaucoma, greater visual field loss or thinner RNFL thickness is associated with reduced postural stability. This postural instability may be a contributing factor in the increased risk of falls among older adults with glaucoma.