Colorectal Cancer Screening Knowledge and Awareness on the Navajo Reservation

B38

This is the first study to have examined colorectal cancer screening knowledge and awareness among the Navajo people residing on the reservation. We first collected data at two annual regional tribal fairs on the Navajo Reservation among 303 adult tribal members who filled out anonymous assessment of colorectal screening knowledge. Next we collected data at two Indian Health Service hospitals in 2007 among 20 adult outpatients to test a culturally adapted instrument on colorectal cancer screening knowledge and awareness. Lastly, we conducted four focus groups in the Navajo language among 30 elders to document their knowledge and awareness of cancer and colorectal cancer screening. Our results show that the majority of the tribal fair participants were Navajo females (78%), with the most common age category of 40-49, a median education of grade 13 (9%); 72% spoke both Navajo and English. Only 16% of the respondents reported having been screened for colorectal cancer. In the hospital survey, the 11 female and 9 male participants had a median age of 58 years. The hospital survey results also show that 55% of the participants had heard about colorectal screening. More importantly, however, 70% of the respondents reported never been screened for colorectal cancer screening. Data from the focus groups show that 77% of the participants were females and the median age was 71. Thirty-six percent of the participants had zero education. Among individuals 50 years and older, 50% reported never having had a colorectal cancer screening, 43% reporting having had one, and the remaining 7% did not. Results of our study show that awareness and interest in colorectal cancer screening among the Navajo is present. The proportion of those reporting undergoing screening is much lower than the national average. The study documents the need for colorectal screening for Navajo people. Results also indicate that the greatest need for colorectal cancer screening efforts is among Navajo individuals who have lower levels of education (0-12) as has been reported for other racial/ethnic groups.