Abstract
Racial disparities in health among African American men (AAM) in the United States are extensive. In contrast to their White counterparts, AAM have more illnesses and die younger. AAM have colorectal cancer (CRC) incidence and mortality rates 25% and 50% higher, respectively, than White men. Due to CRC’s younger age at presentation and high incidence among AAM, CRC screening (CRCS) is warranted at the age of 45 rather than 50, but little is known about younger AAM’s views of CRCS. Employing survey design, the purpose of the study was to describe the male role norms (MRN), knowledge, attitudes, perceived subjective norms, and perceived barriers associated with screening for CRC among a non-random sample of 157 young adult AAM (ages 19–45). Sixty-seven percent of the study sample received a passing knowledge score (85% or better), yet no significant differences were found among the three educational levels (i.e., low, medium, high). More negative attitudes toward CRCS correlated with the participants’ strong perceptions of barriers, but no extremely negative or positive MRN and perceived subjective norms were found. The factors significantly associated with attitudes were family history of cancer (unsure), work status, and perceived barriers. Findings from this study provide a solid basis for developing structured health education interventions that address the salient factors shaping young adult AAM’s view of CRC and early detection screening behaviors.
Highlights
African American men (AAM) have more illnesses, die younger, and have less access to quality healthcare than White men in the United States [1,2,3]
By employing survey research methodology, this study provided valuable information on the male role norms (MRN), knowledge, attitudes, perceived subjective norms, and perceived barriers associated with screening for colorectal cancer (CRC) among young adult AAM
That a couple of contextual variables emerged as strong, independent predictors of attitudes in most of the models – family history of cancer and work status – suggests to health educators the need to www.frontiersin.org consider CRC and CRC screening (CRCS) attitudes from an ecological perspective, where contextual variables such as employment and uncertainty about family history of illnesses play, perhaps, a more salient role than individuals’ knowledge and attitudes
Summary
African American men (AAM) have more illnesses, die younger, and have less access to quality healthcare than White men in the United States [1,2,3]. Since routine screening detects CRC at earlier, more treatable stages, the American Cancer Society, Rex and colleagues with the American College of Gastroenterology, and the U.S Preventive Services Task Force recommend routine screening at age 50 for all men at average-risk using a combination of the following: yearly fecal occult blood test (FOBT), flexible sigmoidoscopy every 5 years, or colonoscopy every 10 years [7,8,9]. Despite evidence that these three recommended early detection screening (EDS) practices can reduce CRC mortality, screening rates remain low among
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