S316 A Cross-Sectional Quality Improvement Study: Assessing the General Public Knowledge of Colorectal Cancer (CRC) by Comparing Races During CRC Awareness Month in March 2022 at a Safety Net Hospital

Abstract

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death and the third most common cause of cancer amongst men and women in the US. Despite being a preventable malignancy, about 7 in 10 US adults are up-to-date with CRC screening. It is predicted that by 2035 there will be a 27.8% increase in mortality secondary to colorectal cancer. In recent years, only approximately half of the Hispanic population in the US has reported obtaining CRC screening, yet by 2050 30% of the US, people will be Hispanic. Methods: A short survey about CRC awareness, provided by the Centers for Disease Control and Prevention (CDC), was randomly handed out to patients, employees, and visitors at Nassau University Medical Center, a 530-bed safety-net hospital in Long Island, NY. The surveys were randomly distributed during National Colorectal Cancer Awareness Month (NCCAM). Statistical analysis was conducted to ascertain the overall percentage of accurate responses and compare Hispanic (H) and non-Hispanic (n-H) responses. Results: 278 individuals (72 H, 206 n-H) completed the CRC awareness survey during NCCAM. Our findings reflect an overall good understanding regarding symptomatology (80.6% [66.6% H; 85.4% n-H]), gender disease (93.5% [90.3% H; 94.7 n-H]), preventive screening (89.2% [95.8% H; 86.9% n-H]), and symptom-related CRC (87.8% [77.7% H; 91.3% n-H]) (Table). We also saw a significant shortfall regarding screening alternatives (45.3% [12.5% H; 56,8% n-H]) and age-starting (24.1% [12.5% H; 28.1% n-H]) and age-ending screenings (22.3% [11.1% H; 26.2% n-H]) (Figure). Conclusion: Since the mid-1980s, the overall CRC incidence has declined steadily due to increased general awareness, uptake of screening, and modifying risk factors. However, the high incidence and mortality rates in the US could be due to a lack of CRC knowledge. Our study provides evidence of CRC awareness deficiency. This disparity among races was highly noticeable, with only 12% of Hispanics compared to 56% of non- Hispanics aware of other screening modalities. Poor socioeconomic status, low education levels, and language barriers could be contributing factors. Interestingly, both groups showed a decreased awareness of the appropriate age to begin colorectal cancer screening. In light of our findings, and with the rapid rise in the Hispanic population throughout the US, further action is warranted to increase awareness of CRC, particularly amongst this vulnerable population, ultimately saving lives.Figure 1.: The percentage of accurate responses to the CRC Awareness Survey among Hispanics and Non-Hispanics patients, employees, and visitors of a large New York safety-net hospital during National Colorectal Cancer Awareness Month Table 1. - CRC Awareness Survey provided by the CDC given on random dates to Hispanics and non-Hispanics patients, employees, and visitors of a large New York safety-net hospital during National Colorectal Cancer Awareness Month Legend:Q: QuestionA: Correct answer Total Answers (n=278) % Correct AnswersHispanics (n=72) % Correct AnswersNon-Hispanics (n=206) % Q1: Who gets colorectal cancer?Men only.Women only.A: Both men and women. 13/2785/278260/278 4.71.893.5 65/72 90.3 195/206 94.7 Q2: Colorectal cancer is the second leading cancer killer in the U.S.A: True.: False. 170/278107/278 61.238.5 45/72 62.5 125/206 60.7 Q3: Getting screened for colorectal cancer can help you prevent the disease.A: True.: False. 248/27822/278 89.27.9 69/72 95.8 179/206 86.9 Q4: If you don’t have any symptoms, it means you don’t have colorectal cancer.: True.A: False. 36/278244/278 12.987.8 56/72 77.7 188/206 91.3 Q5: Screening is recommended to begin at what age?: 40.A: 45.: 50.: 60. 122/27867/27884/2786/278 43.924.130.22.2 9/72 12.5 58/206 28.1 Q6: At what age can you stop getting screened for colorectal cancer?: 60.: 65.: 70.A: 75.: 80. 15/27810/27829/27862/278160/278 5.43.610.422.357.6 8/72 11.1 54/206 26.2 Q7: The only screening test for colorectal cancer is colonoscopy.: True.A: False. 152/278126/278 54.745.3 9/72 12.5 117/206 56.8 Q8: Which of these are symptoms of colorectal cancer?: Blood in or on your stool (bowel movement).: Stomach pain, aches, or cramps that don’t go away.: Losing weight and you don’t know why.A: All of these.: None of these. 34/27810/2784/278224/27811/278 12.23.61.480.64.0 48/72 66.6 176/206 85.4 *For an estimated population of 1,000 on any given day in a large safety-net hospital, 278 participants account for a 95% confidence level (p<0.05).