Exploring Sociocultural Influences On Colorectal Cancer Screening Among Latino Men: Results From a Multi-State Survey

Abstract

Background: The incidence of and mortality from early-onset colorectal cancer (CRC), which occurs in individuals under age 50 years, have been increasing among Latinos. In 2018, the American Cancer Society endorsed a reduction from 50 to 45 years in the recommended age at which average-risk adults should initiate screening. Methods: We partnered with Qualtrics to recruit a multi-state convenience sample of self-identified Latino men from sources such as targeted email lists and social media. Eligibility criteria include men who: self-identified as Hispanic or Latino, resided in New York, Florida, or Texas, and understood English or Spanish. Survey was fielded from February to March 2022; 1,371 responses collected. Primary exposure was masculinity barriers, measured using validated Masculinity Barriers to Medical Care (MBMC) scale. Additional exposures were two subscales from the Male Role Norms, Attitudes, and Perceptions associated with CRC Screening instrument, as well as Hispanic or Latino ethnicity: (1) Mexican or Mexican American; (2) Cuban; (3) Puerto Rican; (4) Other Hispanic or Latino. Our main outcomes were self-report of CRC screening and fecal immunochemical test. Intention to obtain CRC screening secondary outcome. Preliminary analyses restricted to participants in the 45–59, 60–75 age categories (N = 611). Results: Among participants, 26% were of Mexican descent, 31% were Puerto Rican, 14% Cuban, 29% other Latino background. Eighty-one percent planned to obtain CRC screening in the future, although only 40% have used a fecal immunochemical test, and 51% have ever had a sigmoidoscopy or colonoscopy. Latino men of other Hispanic ethnicity were more likely to report taking risks with their own health if it benefits their family (P = 0.018). Mexican men were least likely to report trust in healthcare professionals (P = 0.002), and Cuban men were most likely to report receiving quality medical care (P = 0.001). Conclusions: Masculinity barriers to medical care may play an important role in screening attitudes, intentions, and behaviors. It is important to understand the roles of intersecting social identities including race, ethnicity, gender identity and norms in reducing colorectal cancer disparities.