Racial differences in colorectal cancer screening practices and knowledge within a low-income population

Authors

  • Ann Scheck McAlearney ScD, MS,

    Corresponding author
    1. Division of Health Services Management and Policy, College of Public Health, Ohio State University, Columbus, Ohio
    2. Comprehensive Cancer Center, Ohio State University, Ohio State University, Columbus, Ohio
    • Division of Health Services Management and Policy, College of Public Health, Ohio State University, 1841 Neil Avenue, Cunz Hall 476, Columbus, OH 43210
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    • Fax: (614) 438-6859.

  • Katherine W. Reeves MPH,

    1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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  • Stephanie L. Dickinson MAS,

    1. Center for Population Health and Health Disparities, Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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  • Kimberly M. Kelly PhD,

    1. Comprehensive Cancer Center, Ohio State University, Ohio State University, Columbus, Ohio
    2. Human Cancer Genetics, Ohio State University, Columbus, Ohio
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  • Cathy Tatum MA,

    1. Center for Population Health and Health Disparities, Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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  • Mira L. Katz PhD,

    1. Comprehensive Cancer Center, Ohio State University, Ohio State University, Columbus, Ohio
    2. Division of Health Behavior and Health Promotion, College of Public Health, Ohio State University, Columbus, Ohio
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  • Electra D. Paskett PhD

    1. Comprehensive Cancer Center, Ohio State University, Ohio State University, Columbus, Ohio
    2. Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio
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  • All participants provided written informed consent, and the study was approved by the institutional review boards at Wake Forest University Medical Center and Ohio State University.

Abstract

BACKGROUND.

Although colorectal cancer (CRC) is the third leading cause of cancer death among US women and is particularly deadly among African Americans, CRC screening rates remain low. Within a low-income population of women, the authors examined racial differences in practices, knowledge, and barriers related to CRC screening.

METHODS.

Face-to-face interviews were conducted with 941 women (white, n = 186; African American, n = 755) older than age 50 years who were living in subsidized housing communities in 11 cities in North and South Carolina. Women were asked questions about their CRC screening history and their knowledge and beliefs concerning CRC screening.

RESULTS.

Half (49%) of the women interviewed were within CRC screening guidelines, and this did not vary by race (P = .17). However, African American women were half as likely as white women to report having had a screening colonoscopy within the past 10 years (odds ratio [OR], 0.46; P < .001). Awareness of tests for CRC was low overall (39%) and was lower among African Americans than whites (OR, 0.44; P < .001). Compared with white women, African American women were less likely to report embarrassment as a barrier (OR, 0.59; P = .008) and more likely to report lack of insurance coverage (OR, 1.75; P = .098).

CONCLUSIONS.

Efforts must continue to increase women's knowledge of both CRC screening tests and colon cancer risk factors. Among these low-income women, routine encounters with the healthcare system may present opportunities to reduce deficits in CRC knowledge and to improve overall CRC screening rates. Cancer 2008. © 2007 American Cancer Society.

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