Colorectal Cancer Screening Services Research Articles

Attitudes and beliefs about colorectal cancer among Mexican Americans in communities along the US-Mexico border.

The purpose of this study was to examine Mexican American knowledge, attitudes, and beliefs about colorectal cancer and barriers to receiving colorectal cancer screening exams. We developed an open-topic focus group schedule that addressed knowledge, attitudes, and beliefs about screening for colorectal cancer and identified cultural issues to be considered when developing educational interventions to increase screening participation. Focus groups were used to elicit participant responses. Two small communities (colonias) along the US-Mexico border. Mexican Americans ages > or = 50 years. A total of 43 individuals (20 men and 23 women) participated in the focus groups, each of which lasted approximately 90 minutes. Few focus group participants had ever heard of colorectal cancer or specific screening exams to detect early forms of cancer. Participants identified cost of medical care and embarrassment about receiving colorectal exams as barriers to screening participation. Respondents commonly expressed fatalistic attitudes about their chances of recovering from cancer, some preferred not to know if they had cancer or believed that they would refuse treatment if diagnosed with cancer. Nevertheless, many participants noted that strong support from family and friends or a strong will would allow one to survive cancer. Interventions to improve participation in screening services for colorectal cancer should focus on reducing the influences of cost and embarrassment and improving levels of knowledge about colorectal cancer and the need for screening.

Experiences in providing a screening service for colorectal cancer from a pathology laboratory

To provide a colorectal cancer screening service for the general public, based on the detection of blood in faeces, that was effective, affordable and convenient. Kits for collecting faecal specimens were sold directly to the public and, after collecting three specimens, kits were transported to the laboratory for testing by an immunochemical procedure involving a positive cut-off value. Reports were sent to participants and their nominated doctors who were requested to provide information on participants testing positive. Over a 10-year period, 35 139 kits were analysed and 5.63% were positive. After follow-up, 7.4% of positive testing participants were found to have colorectal cancer, 23.4% adenomas, 34.6% miscellaneous non-neoplastic pathology and in 25.0% no abnormality was found. Sixty-six per cent of cancers were early stage, Dukes stages A and B. There were 35 139 kits processed on 16 240 individuals, indicating that a number were repeat testing. The screening service was able to detect a high yield of colorectal pathology, especially early stage neoplasia which is curable, and encouraged repeat testing. Education of doctors about how to investigate a positive test, and of participants about symptoms, have been important lessons arising from this screening service.