Colorectal cancer screening: Understanding the health literacy needs of hispanic rural residents.

Angelina R Wittich,Melissa A Valerio,L Aubree Shay,Elisabeth M De La Rosa,Belinda Flores,Taylor Mackay

doi:10.3934/publichealth.2019.2.107

Abstract

PurposeHispanics residing in rural areas are among those who are least likely to be screened for colorectal cancer (CRC) and more likely to present with late stage CRC than other racial or ethnic groups. We conducted a pilot study utilizing a mixed-method approach to explore perceptions of CRC and CRC screening among Hispanic adults residing in South Texas rural communities and to identify health literacy needs associated with CRC screening uptake.MethodsA convenience sample of 58 participants, aged 35–65, were recruited to complete questionnaires and participate in focus groups, ranging in size from 4 to 13 participants. Six focus groups were conducted across 3 adjacent rural counties. A semi-structured moderator's guide was designed to elicit discussion about participants' experiences, knowledge, and perceptions of CRC and CRC screening.FindingsLack of knowledge of CRC and CRC screening as cancer prevention was a common theme across focus groups. A majority, 59%, reported never been screened. Thirty-nine percent reported they had been screened for colon cancer and 5% reported they did not know if they had been screened. Participants with lower educational levels perceived themselves at high risk for developing CRC polyps, would not want to know if they had CRC, and if they did have CRC, would not want to know until the very end. Limited information about CRC and CRC screening, a lack of specialized providers, limited transportation assistance, and compromised personal privacy in small-town medical facilities were perceived to be barriers to CRC screening.ConclusionsLow screening rates persist among rural Hispanics. Improving CRC screening literacy and addressing factors unique to rural Hispanics may be a beneficial strategy for reducing screening disparities in this at-risk population.

Highlights

The leading cause of death among Hispanics in the United States is cancer [1]
We conducted a pilot study utilizing a mixed-method approach to explore perceptions of colorectal cancer (CRC) and CRC screening among Hispanic adults residing in South Texas rural communities and to identify health literacy needs associated with CRC screening uptake
The present study focused on exploring experiences, knowledge, and perceptions of CRC and CRC screening and health literacy deficits that might contribute to low screening rates among Hispanics residing in rural communities of the South Texas Coastal Bend

Summary

Introduction

The leading cause of death among Hispanics in the United States is cancer [1]. In the United States, colorectal cancer (CRC) is the second leading cause of all cancer deaths [2], and the third leading cause of cancer deaths among Hispanic men and women, respectively [1]. According to the Texas Cancer Registry, Hispanics have lower CRC mortality rates than Whites or African Americans. In the Public Health Region 11 (PH 11) where the study participants reside, Hispanics make up 85% of the population and have higher incidence and mortality rates than Whites, which make up 13% of the population. African Americans generally have higher incidence and mortality rates than Hispanics and Whites, in Public Health Region 11, they represent only 1% of the population. In Texas, CRC is the second leading cause of deaths, second to lung cancer [2]

Results

Discussion

Conclusion