Abstract

Abstract Background: Colorectal cancer (CRC) is the third leading cause of cancer death in the United States (US) but can be prevented with routine screening. A significant racial disparity exists among African Americans (AAs) with higher CRC incidence and mortality rates than other races, in particular in some rural areas, such as the lower Mississippi Delta regions including 17 counties in Arkansas. However, this disparity cannot be explained solely by lack of screening. Previous studies have suggested that this health disparity may be related to limited access to healthy food, lack of physical activity, and lack of facilities for cancer screening. Additional research in Arkansas is needed on the determinants of these disparities to develop actionable prevention strategies. Methods: An engagement approach known as a community review board (CRB) was used in this study. A CRB is a one-time meeting with community member experts who have personal experience with the research issue, and these experts provide feedback on the study. Two CRBs consisting of AAs age 45-75 were conducted, in urban, central (Little Rock, n=6) and rural, lower Delta (Helena, n=10) Arkansas communities, to better understand these communities’ perspectives on CRC and screening. We also discussed the community members’ willingness to participate in a study to look at the association between diet and food security with CRC and the barriers to participate. Differences in the viewpoints of the two CRBs were compared and documented. Results: Both rural and urban CRB respondents indicated their willingness to believe and listen to other community members, and generally do not go to the doctor unless they are sick. A lower percentage of our rural CRB participants (30%) had been screened for CRC as compared to our urban CRB participants (83%). When invited to participate in research studies, rural CRB respondents preferred to learn about the results of the study in a public, community forum. These older AA community members, both rural and urban, thought communities could benefit from more information disseminated related to these topics. Additionally, the rural CRB participants were more comfortable discussing CRC incidence and mortality with family compared to urban CRB participants. Conclusions: From this study, those in this rural community are more comfortable discussing CRC in the community-based discussion and with their family, and this may be related to the fact that they live in a CRC mortality hotspot in the Delta region. In addition, because members of these communities, both rural and urban, mentioned the need for more available information about CRC and screening we will hold virtual community forums with residents of Little Rock and Phillips County to discuss CRC, screening, and diet to inform and learn more from these Arkansas communities. We will also use the community members’ feedback to improve our research project in which we will analyze the association between food security, diet, and CRC. Citation Format: Eryn K. Matich, Rachel Hale, Nicola Spencer, M. Kathryn Stewart, L. Joseph Su, Ping-Ching Hsu. Colorectal cancer health disparity among African Americans: A qualitative study at the community level, exploring the connection between low access to resources, diet, and colorectal health [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-038.

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