Search

Purpose: We sought to assess factors related to colorectal cancer (CRC) screening adherence among immigrant, Hispanic women in Harlem, New York City., Method: Adherence for colonoscopy and fecal occult blood test (FQBT) screening was measured among 255 women based on self-reported screening behaviors using American Cancer Society guidelines., Results: Univariate results showed that age, language of the interview (English/Spanish), years in the United States, physician recommendation for either test, marital status (living alone/living with someone), and mammography adherence were associated with CRC screening adherence (p's < .05). In the multivariate analysis, having an age greater than 65 years, being interviewed in Spanish, having lived in the United States longer, having a regular doctor and a physician recommendation, and being currently adherent for mammography were associated with higher CRC screening adherence., Conclusion: Among this sample, there proved to be differences between having ever been screened and adherence with a greater proportion of women having ever completed either colonoscopy and/or FOBT compared to women who were adherent (72.9% vs 58.8%). Therefore, it is important to determine factors associated with adherence, not just screening utilization, in order to design strategies to increase adherence among immigrant Hispanic women.

Background: Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the United States. Underrepresented minorities suffer disproportionately from CRC largely because of disparities in CRC screening rates, particularly by endoscopic methods. This study evaluates the association between socioeconomic, medical and psychosocial factors and the use of endoscopy in low-income minority women., Methods: The participants were recruited from community health fairs, tenant association meetings, senior centers and local medical clinics. A survey instrument was administered to the minority women., Results: Eighty-one women age >50 were included in this analysis (44 African Americans and 37 Hispanics). The two ethnic groups were demographically similar. The factors associated with having had endoscopy were language spoken (English versus Spanish), physician recommendation, cancer cons and decisional balance (difference between cancer cons and cancer pros). When endoscopy was modeled as a function of decisional balance and language spoken, only decisional balance was a significant predictor of endoscopy., Conclusions: Physician recommendation and decisional balance have a tremendous influence on whether minority women undergo endoscopy. These data suggest that if physicians increase their communication with patients regarding the benefits of screening and address patients concerns, adherence with endoscopic CRC screening can be improved in minority women.

African-American and Hispanic women receive fewer indicated cancer early detection services than do majority women. Low rates of cancer screening may, in part, explain the disproportionately higher rates of cancer deaths in this population. The aim of this qualitative study was to explore through individual interviews the perceptions of barriers and facilitators of colorectal, cervical and breast cancer screening among 187 low-income, primarily minority women in four New-York-City-based community/migrant health centers. We identified various barriers and facilitators within each of these categories. Clinician recommendation was the most commonly cited encouragement to cancer screening. Other facilitators of cancer screening identified by patients included personal medical history, such as the presence of a symptom. The perception of screening as routine was cited as a facilitator far more commonly for mammography and Pap tests than for either of the colorectal screenings. Less commonly cited facilitators were insurance coverage and information from the media. The most common barriers were a lack of cancer screening knowledge, patients' perception of good health or absence of symptoms attributable to ill health, fear of pain from the cancer test and a lack of a clinician recommendation. Using standard qualitative techniques, patients' responses were analyzed and grouped into a taxonomy of three major categories reflecting: (1) patients' attitudes and beliefs, (2) their social network experience and (3) accessibility of services. This taxonomy may serve as a useful framework for primary care providers to educate and counsel their patients about cancer screening behaviors.