Abstract B79: Colonoscopy screening in a community sample of African Americans

Abstract

Abstract Background: Colonoscopy is an efficacious strategy for reducing morbidity and mortality from colorectal cancer. Low utilization of colonoscopy contributes to racial disparities in colorectal cancer outcomes. Predictors of colonoscopy have been examined in clinical samples, but decisions about cancer screening are made in a multidimensional context that includes social, psychological, socioeconomic factors. Evaluating the association between colonoscopy utilization and multidimensional factors in a community-based sample is needed to understand how screening decisions are made in a community context. Objectives: To evaluate the independent associations between social, psychological, socioeconomic, and clinical factors on colonoscopy use in a community-based sample of urban African American adults. Methods: Participants were 236 African American men and women ages 50-75 who were enrolled in a community-based navigation program for cancer control. Data on colonoscopy use and socioeconomic (e.g., income), clinical (e.g., provider communication about colonoscopy), social (e.g., neighborhood satisfaction), and psychological factors (e.g., self-efficacy) were obtained by self-report during a baseline telephone interview that was completed prior to navigation. Results: Overall, 58% of participants reported having a colonoscopy. Factors having significant independent associations with colonoscopy included older age (OR=1.15, 95% CI=1.07, 1.24, p=0.0002), greater neighborhood satisfaction (OR=1.86, 95% CI=1.05, 3.30, p=0.03), physician recommendation (OR=12.69, 95% CI=5.33, 30.20, p=0.0001), greater self-efficacy (OR=2.60, 95% CI=1.29, 5.24, p=0.01) and higher income (OR=2.70, 95% CI=1.35, 5.37, p=0.005). Participants with greater levels of present temporal orientation were also more likely to report having a colonoscopy compared to those with lower levels (OR=1.18, 95% CI=0.99, 1.41, p=0.06) Conclusions: Colonoscopy is sub-optimal in a community-based sample of African Americans. In addition to psychological factors, participants who were more satisfied with their neighborhood conditions and those who had greater levels of present temporal orientation were likely to have a colonoscopy. Social and cultural factors may need to be addressed to enhance colonoscopy use among African Americans. Citation Format: Melanie S. Jefferson, Vanessa Briggs, Ernestine Delmoor, Jerry C. Johnson, Chanita Hughes-Halbert. Colonoscopy screening in a community sample of African Americans. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B79. doi:10.1158/1538-7755.DISP13-B79