Abstract C163: Colorectal cancer screening: Perspectives from farmers and ranchers in the Midwest

Annually, in the United States, over 140,000 people are diagnosed with colorectal cancer (CRC) and 52,000 people die from the disease. Rural states such as Nebraska and Missouri report the highest CRC incidence rates nationally, ranking 12th and 13th, respectively. Notably, CRC incidence is higher in rural (42.8 per 100,000) than in urban (38.0 per 100,000) communities. Agricultural producers—farmers and ranchers—are a key rural population that remain understudied in cancer prevention and control, particularly regarding CRC screening. Therefore, in this study, we surveyed agricultural operators in Nebraska and Missouri to: 1) Identify factors associated with being current on CRC screening, 2) examine the influence of life orientation, health beliefs about CRC (e.g., perceived benefits and barriers of CRC screening, perceived risk and severity about CRC, and social norms) on CRC screening intent and 3) assess whether age and gender modify these associations. A survey was conducted using Farm Market iD data (2018, 2020) to contact adults aged 50 and older in Nebraska and Missouri. Of 523 respondents, 406 were agricultural operators (74% male). The survey measured life optimism (Life Orientation Test-Revised, 6 items), perceived benefits (5 items), perceived barriers (5 items), social norms (2 items), and perceived risk and severity about CRC (3 items). Structural equation modeling was used to analyze predictors of intent to schedule CRC screening in the next 12 months, with model fit assessed via AIC and BIC. Monte Carlo integration provided maximum likelihood estimates due to the binary outcome variable. All constructs demonstrated strong psychometric properties and unidimensionality. Neither life optimism nor perceived barriers predicted perceived risk and severity about CRC. Perceived benefits of screening were strongly associated with perceived risk and severity of CRC. Social norms (perceived views of important others) did not influence screening intent. Perceived risk and severity about CRC significantly predicted intention to schedule CRC screening within 12 months (odds ratio 1.70, 95% CI: 1.22–2.37). Perceived benefits did not directly predict screening intent (p=0.95). Age and gender were not significant modifiers of these associations. Among agricultural operators in Nebraska and Missouri, perceived benefits of CRC screening predicted health beliefs about CRC, which in turn predicted intention to screen within a year. Perceived barriers, social norms, age, and gender did not significantly influence screening intent. These findings highlight the importance of targeting health beliefs—especially perceived risk and severity—in interventions to improve CRC screening uptake in rural agricultural populations. References 1. National Cancer Institute. State Cancer Profile. State Cancer Profiles. Accessed June 17, 2025. 2. Semprini J, et al. 2024. Rural-urban cancer incidence and trends in the United States, 2000 to 2019. Cancer Epidemiology, Biomarkers & Prevention. 2024; 33:1012-22. Citation Format: Shinobu Watanabe-Galloway, Cheryl Beseler, Jungyoon Kim, Roma Subramanian, Karen Funkenbusch, Emma Hymel, Aaron Yoder. Colorectal cancer screening: Perspectives from farmers and ranchers in the Midwest [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C163.