Sociodemographic Correlates of Stage of Adoption for Colorectal Cancer Screening in African Americans

• Authors: Jennifer Christie, Emory University; Lina Jandorf, Emory University; Steven Itzkowitz, Emory University; Ethan Halm, Emory University; Kim Freeman, Emory University; Sheba King, Mount Sinai School of Medicine; Rayhana Dhulkifl, Emory University; Michelle McNair, Mount Sinai School of Medicine; Linda Thelemaque, Mount Sinai School of Medicine; Catalina Lawsin, Mount Sinai School of Medicine; Katherine Duhamel, Emory University
• Journal Title: Ethnicity and Disease
• Volume: Volume 19, Number 3
• Publisher: International Society on Hypertension in Blacks; 1999 | 2009, Pages 323-329
• Type of Work: Article | Post-print: After Peer Review
• Subjects: Health Sciences, Oncology; Health Sciences, Public Health
• Keywords: Colorectal Cancer Screening; African Americans; Cancer Prevention

Abstract

Objectives African Americans have the highest incidence and mortality rates from colorectal cancer in the United States. Endoscopic screening, while effective in reducing both, is greatly underutilized. This research sought to understand sociodemographic factors related to stage of readiness for endoscopic screening. Design One hundred fifty nine African American women (76.1%) and men (mean age=57.0 years) who were non-adherent to endoscopic screening guidelines were recruited and asked to complete semi-structured interviews. Setting Participants were all being seen for a non-acute primary care medical visit at one of two urban hospitals. The theoretical framework that informed this study was the Transtheoretical Model (TTM) and the emphasis on Stage of Change or intention for undergoing endoscopic screening. Main Outcome and Measures Based on their stage of readiness to undergo screening, 67 (42%) were categorized as precontemplative (Has no plans to have a colonoscopy) while 92 were categoriezed as being in a contemplative or preparation stage. Using chi-square and Student t-tests, differences were examined between the two groups. Results No sociodemographic variables distinguished the two groups. However, people in the contemplative/preparation group were more likely to: have a regularly seen healthcare professional (63.7% vs 36.3%; P=.005), have had a previous recommendation for screening (65.7% vs 34.3%; P=.003); had heard of a colonoscopy (63.6% vs 36.4%; P=.000) and have been told by a healthcare professional that they needed a colonoscopy (73.1% vs 26.9%; P=.000). Conclusions This study helps us to better understand the relevance of sociodemographic characteristics that may be associated with completing endocscopic colorectal cancer screening. In addition, we confirm that physician recommendation and individual awareness of the procedure are significant factors in readiness to get screened.