Abstract
Ethnic and racial minority groups in the U.S. receive fewer colorectal cancer (CRC) screening tests and are less likely to be up-to-date with CRC screening than the population as a whole. Access, limited awareness of CRC and barriers may, in part, be responsible for inhibiting widespread adoption of CRC screening among racial and ethnic minority groups. The purpose of this study was to examine the role of self-efficacy, fatalism and CRC risk perception across racial and ethnic groups in a diverse sample. This study was a cross-sectional analysis from baseline measures gathered on a group of patients recruited into a trial to track colorectal cancer screening in underserved adults over 50. Out of 470 Participants, 42% were non-Hispanic; 27% Hispanic and 28% non-Hispanic White. Hispanic and non-Hispanic Blacks were more likely to have fatalistic beliefs about CRC than non-Hispanic Whites. Non-Hispanic Blacks perceived higher risk of getting colon cancer. Self-efficacy for completing CRC screening was higher among Non-Hispanic Blacks than among Hispanics. Racial and ethnic differences in risk perceptions, fatalism and self-efficacy should be taken into consideration in future CRC interventions with marginalized and uninsured populations.
Highlights
Colorectal cancer (CRC) is one of the leading causes of death and third most common cancer in the U.S [1]
The analysis showed significant differences in response to colorectal cancer (CRC) screening questions by race/ethnicity
Self-efficacy did not show a significant association with ethnicity/race, non-Hispanic Blacks had a significantly greater self-efficacy for CRC screening than Hispanics (OR=1.66, 95% CI (1.08, 2.55), p=0.02)
Summary
Colorectal cancer (CRC) is one of the leading causes of death and third most common cancer in the U.S [1]. The American Cancer Society reported in its 2012 Colorectal Cancer Facts and Figures that an expected 148,810 new cases of colon cancer would be reported and 49,960 of those would result in death If detected early it is preventable and curable [2]; low-income and minority groups carry the majority of disease burden and have poorer survival once diagnosed [3,4] when compared to upper and middle income NonHispanic Whites. Incidence and mortality disparities across racial and ethnic groups are likely due to many factors These include differential access to medical care and screening tests, differential adherence to screening test recommendations, genetic variations, and cultural and behavioral health differences for factors such as diet and physical activity that relate to the development of CRC [5,6,7,8].
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