Reluctance to Screening Colonoscopy in Arab Americans: A Community Based Observational Study

Abstract

To explore compliance of Arab-Americans to colorectal cancer (CRC) screening and identify the barriers for non-compliance. An observational community based study. Arab-American Friday prayer attendees' ≥50years in three mosques in Dearborn, MI volunteered. Demographics, health insurance status, screening history, availability of a primary care physician (PCP) and the ability to communicate in Arabic were inquired. The responses were compared using a student t test between respondents who have had CRC screening with colonoscopy and those who have not had any screening tests. A p value of 0.05 or lower was considered statistically significant. Total number surveyed was 130. Average age is 64years. Males were 76% (99) and females 24% (31). More than 50% were Lebanese and 28% were from Yemen. Majority had health insurance (89%), and 86% had a primary care physician of which 79% of them spoke Arabic. Half of the participants had colonoscopy mostly for screening purposes. Fifty-eight (45%) participants did not have CRC screening. Majority of the females (72.4%) had colonoscopy compared to 46.8% of the males (p value=0.016). The mean length of stay in the U.S was 39.16years in the colonoscopy group compared to 30.77years in the non-screening group (p value=0.006). Participants without a PCP did not have CRC screening (77.8%) (p value=0.005). Participants with a non-Arabic speaking PCP had more colonoscopy rates (77.3%) compared to those with an Arabic speaking PCP (50%) (p value=0.027). More Lebanese had colonoscopy (71.9%) compared to 25.7% of the surveyed Yemenis (p value=0.00). Discomfort, unawareness about CRC screening, and nonrecommendation by PCP were reported barriers. Arab-Americans have lower screening colonoscopy rates. Unfamiliarity of the importance of screening is a principal issue. Having a non-arabic speaking PCP is beneficial. Better education to this population about the benefits and ease of screening could increase adherence to screening for this population.