Effect of Baseline Chronic Conditions on Screening Adherence among Older African American Men

Purpose/Goals of Project: We examined the effect of baseline comorbidities on screening adherence in a sample of 703 older (ages 55+ years) African American (AA) men enrolled in a case management intervention in a longitudinal cancer screening trial. Methodology: The 703 men were randomly assigned to a case management retention trial intervention group (IG, n=352) or a case management control group (CG, n=351). The case managers referred intervention group participants to community agencies that provided services requested by participants. Results: Regardless of group assignment, participants with comorbidities were not less likely to adhere to trial screening than participants without comorbidities. Exceptions were current smokers, participants with bronchitis, and those with arthritis. IG participants who were current smokers were marginally less likely (56.0%) than others to adhere to the prostate specific antigen (PSA) test for prostate cancer screening (p=0.052). IG participants who reported having chronic bronchitis had a much lower chest x-ray screening (for lung cancer) adherence rate (28.6%) than participants in the other three groups (p=0.045). CG participants who reported having arthritis had the lowest adherence rate to flexible sigmoidoscopy for colorectal cancer screening, 40.5%, compared to the other three groups (p=0.022). Implications: In general, older African American men with comorbidities appear to be excellent candidates for participation in longitudinal cancer screening trials, although smokers have lower adherence rates. Sustainability: Future studies could examine the relationship between baseline health history and adherence to other types of cancer screening among older African American men and among other population groups.