Predictors of Colorectal Cancer Screening in African Americans

PURPOSE: Early detection can reduce colorectal cancer (CRC) mortality by 15% to 33%, and screening is widely recommended for average-risk adults beginning at age fifty. Factors that facilitate screening include higher income, higher education, old age, strong social ties and supportive relationships. Our goal is to assess the predictors (demographic & socioeconomic factors, cancer screening knowledge, attitude & beliefs, cancer fatalism and social networks) of CRC among African American (AA) men and women. METHODS: The data was collected as a part of a larger study evaluating the effects of three intervention strategies (one-on-one education, group education, reduced out-of–pocket expenses) on CRC screening in an AA population. Data analyses were done using SAS 9.2. in the following sequence: 1) the distributions of predictors by participant status and 2) the associations between CRC screening outcomes by predictors. The Logistic Regression model was used to determine the impact of the measures. RESULTS: 312 men and women participated in the study, 64 (20.5%) of participants were screened for CRC after six months from baseline. Higher knowledge, attitude, and beliefs scores about screening (p<0.005; 1.21(1.04 - 1.41)) and cancer fatalism scores (p<0.011; 1.22(1.07-1.39)) were the strongest predictors for screening for CRC. CONCLUSION: Higher cancer screening knowledge, attitude, beliefs, and higher level of fatalism are predictors of increased CRC screening rates among AA. The screening rate of 20% of study sample participants participated in an educational program indicated that there are still barriers to overcome.