Cancer screening practices of African Americans in Forsyth County, NC

A102

Cancer disparities exist for African Americans in Forsyth County, North Carolina. Understanding the prevalence and correlates of cancer screening can provide vital information to health care providers to help address and alleviate this disparity. We conducted a survey of the cancer screening and cancer knowledge, attitudes and behaviors of African Americans in Forsyth County, North Carolina as part of the Faith Community Health Commission (FCHC) pilot project for the Piedmont Alliance for Cancer Research and Education (PACRE). The survey utilized in this study was based largely on the Centers for Disease Control’s Behavioral Risk Factor Surveillance System Survey (BRFSS). The survey was conducted in two phases. In phase I, FCHC staff distributed the survey instrument to congregation members in seven largely African American churches. In phase two, residents of three low income housing communities participated in the survey, administered by staff of the Wake Forest University Survey Research Center. The participants were African American men and women >40 years of Participants received a $15 gift certificate for completing the survey. Data were transformed and entered into the Statistical Program for the Social Sciences (version 11.0, Chicago, Ill.) for analyses. A total of 756 surveys had completed data for eligibility variables. The average age of the sample was 54.1 years. 45% of the sample had a high school degree or less, and 20.1% had no health care coverage. Regarding cancer screening, 52.6% of men indicated that they had ever had a PSA test, and, of those, 63.6% had had a PSA within the past year. PSA testing was associated with younger age, being married, having a regular doctor, having insurance, and having a family history of prostate cancer. 67.9% of men had ever had a digital rectal exam, 56.3% of whom had had the test within the past year. Ever having a DRE was associated with being married, having a regular doctor, and having insurance. 88.6% of women had ever had a mammogram, 65.1% of whom had this test within the past year. Ever mammography screening was associated with older age, being married, having a regular doctor, and having insurance. 89.6% of women had ever had a clinical breast exam, 72.5% of whom had the test within the past year. Of respondents >50 year of age and older, less than half had ever had a blood stool test (46.6%) or colonoscopy (49.6%) for colorectal cancer screening, and of those 49.5% and 43.5%, respectively. Blood stool and colonoscopy testing was associated with older age, being married, having a doctor, and having insurance, while blood stool testing was also associated with having a higher education. Cancer screening rates for African Americans in Forsyth County, North Carolina are particularly low for prostate and colorectal cancer. Further research will examine additional demographic, health and cancer knowledge, attitude and behavioral correlates of screening practices in this population to guide prevention efforts.