Z Gastroenterol 2008; 46: 47-51
DOI: 10.1055/s-2007-963489

© Georg Thieme Verlag KG Stuttgart · New York

Gender Differences in FOBT Use: Evidence from a Large German Survey

M. Sieverding1 , U. Matterne1 , L. Ciccarello1
  • 1Ruprecht-Karls-Universität Heidelberg, Germany
Further Information

Publication History

Publication Date:
26 March 2008 (online)


We examined prevalence and correlates of fecal occult blood testing (FOBT) uptake in a sample of men and women aged 50 to 70 years without a personal history of cancer (n = 15 810). The data was collected in 2004 through the Health Care Access Panel (HCAP), a nationally generalizable survey of German households. A pronounced gender difference in FOBT use emerged. Women reported regular use more often, while men reported irregular use with a higher frequency. Nearly every third men (29.6 %), compared to 17.5 % of the women had never made use of FOBT. The influence of socioeconomic factors on FOBT uptake was negligible. Family history of cancer was significantly associated with FOBT but the effect was very small. Use of medical checkups and physician recommendation were the most important predictors of FOBT use in men and women. Gender differences in use of medical checkups and physician recommendation to undergo an examination for the early detection of cancer partly mediated the gender differences in FOBT use.


  • 1 Courtenay W H. Constructions of masculinity and their influence on men’s well-being: A theory of gender and health.  Social Science & Medicine. 2000;  50 1385-1401
  • 2 Wardle J, Miles A, Atkin W. Gender differences in utilization of colorectal cancer screening.  Journal of Medical Screening. 2005;  12 20-27
  • 3 O’Brien R, Hunt K, Hart G. ‘It’s caveman stuff, but that is to a certain extent how guys still operate’: men’s accounts of masculinity and help seeking.  Social Science & Medicine. 2005;  61 503-516
  • 4 Gnauck R. Screening for colon cancer in Germany.  Tumori. 1995;  81 30-37
  • 5 Hardcastle J D, Chamberlain J O, Robinson M H. et al . Randomised controlled trial of fecal-occult-blood screening for colorectal cancer.  Lancet. 1996;  348 1472-1477
  • 6 Brevinge H, Lindholm E, Buntzen S. et al . Screening for colorectal neoplasia with fecal occult blood testing compared with flexible sigmoidoscopy directly in a 55 - 56 years’ old population.  International Journal of Colorectal Disease. 1997;  12 291-295
  • 7 U. K. Colorectal Cancer Screening Pilot Group . Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom.  BMJ. 2004;  329 133
  • 8 Faivre J, Dancourt V, Lejeune C. et al . Reduction in colorectal cancer mortality by fecal occult blood screening in a French controlled study.  Gastroenterology. 2004;  126 1674-1680
  • 9 Segnan N, Senore C, Andreoni B. et al . Randomized Trial of Different Screening Strategies for Colorectal Cancer: Patient Response and Detection Rates.  J Natl Cancer Inst. 2005;  97 347-357
  • 10 Becker N. Epidemiological aspects of cancer screening in Germany.  Journal of Cancer Research & Clinical Oncology. 2003;  129 691-702
  • 11 Knöpnadel J, Altenhofen L, Lichtner F. et al .Früherkennung des Darmkrebses und möglicher Vorstufen - Wissenschaftliche Reihe des Zentralinstituts, Band 59 (Early detection of colorectal cancer and possible pre-stages). Köln; Deutscher Ärzteverlag 2005
  • 12 Sieg A, Theilmeier A. Ergebnisse der Vorsorge-Koloskopie 2005 - Internet-basierte Dokumentation (Results of coloscopy screening in 2005 - an Internet-based documentation).  Deutsche Medizinische Wochenschrift. 2006;  131 379-383
  • 13 McQueen A, Vernon S W, Meissner H I. et al . Are there gender differences in colorectal cancer test use prevalence and correlates?.  Cancer Epidemiol Biomarkers Prev. 2006;  15 782-791
  • 14 Altenhofen L. Hochrechnung zur Akzeptanz von Gesundheitsuntersuchungen und Krebsfrüherkennungsuntersuchungen bei gesetzlich Versicherten (Extrapolation data regarding acceptance of health check-ups and early detection cancer screenings for the population of people covered by public health insurance). Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland 2005
  • 15 Cokkinides V E, Chao A, Smith R A. et al . Correlates of underutilization of colorectal cancer screening among U. S. adults, age 50 years and older.  Preventive Medicine. 2003;  36 85-91
  • 16 Seeff L C, Nadel M R, Klabunde C N. et al . Patterns and predictors of colorectal cancer test use in the adult U. S. population.  Cancer. 2004;  100 2093-2103
  • 17 Slattery M L, Kinney A Y, Levin T R. Factors associated with colorectal cancer screening in a population-based study: the impact of gender, health care source, and time.  Preventive Medicine. 2004;  38 276-283
  • 18 Wardle J, McCaffery K, Nadel M. et al . Socioeconomic differences in cancer screening participation: comparing cognitive and psychosocial explanations.  Social Science & Medicine. 2004;  59 249-261
  • 19 Zapka J G, Puleo E, Vickers-Lahti M. et al . Healthcare system factors and colorectal cancer screening.  American Journal of Preventive Medicine. 2002;  23 28-35
  • 20 Potthoff P, Heinemann L A, Güther B. A household panel as a tool for cost-effective health-related population surveys: validity of the “Healthcare Access Panel”.  German Medical Science. 2004;  2 Doc5 , http://www.egms.de/en/gms/2004-2/000015.shtml
  • 21 Federal Statistical Office .Statistical Yearbook for the Federal Republic of Germany. Wiesbaden; Statistisches Bundesamt (Federal Statistical Office) 2005
  • 22 Addis M E, Mahalik J R. Men, masculinity, and the contexts of help seeking.  American Psychologist. 2003;  58 5-14
  • 23 Glanz K, Grove J, Le Marchand L. et al . Underreporting of Family History of Colon Cancer: Correlates and Implications.  Cancer Epidemiol Biomarkers Prev. 1999;  8 635-639
  • 24 Gilbert A, Kanarek N. Colorectal cancer screening: Physician recommendation is influential advice to Marylanders.  Preventive Medicine. 2005;  41 367-379
  • 25 Lemon S, Zapka J, Puleo E. et al . Colorectal cancer screening participation: Comparisons with mammography and prostate-specific antigen screening.  American Journal of Public Health. 2001;  91 1264-1272
  • 26 Hall H I, Van Den Eeden S K, Tolsma D D. et al . Testing for prostate and colorectal cancer: comparison of self-report and medical record audit.  Preventive Medicine. 2004;  39 27-35

Monika Sieverding

Department of Psychology, Ruprecht-Karls-Universität Heidelberg

Hauptstr. 47 - 51

69117 Heidelberg


Phone: ++ 49/62 21/54 73 72

Fax: ++ 49/62 21/54 73 25

Email: monika.sieverding@psychologie.uni-heidelberg.de