Abstract B88: Factors influencing colorectal cancer screening in low-income African Americans in Tennessee

Background: African Americans bear a disproportionately high burden for colorectal cancer. They have higher incidence and mortality from colorectal cancer and have poorer 5-year survival rates than their Caucasian counterparts. Potential explanations for these disparities include poorer utilization of early detection services and poorer access to beneficial treatments.

Objectives: The purpose of this study was to examine the barriers to colorectal cancer screening to improve understanding of the issues that need to be addressed to motivate African Americans to engage in early detection of colorectal cancer.

Methods: As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, health care access and utilization, and screening practices for various cancers in low-income African Americans. Participants were recruited from African American communities in Nashville, Chattanooga, and Memphis. For this study, only African Americans 50 years and older were selected from the Meharry CNP community survey database. The final sample size was 403. The primary outcome of interest was screening for colorectal cancer with a colonoscopy/sigmiodoscopy within the past five years.

Results: The screening rate for receiving a colonoscopy/sigmiodoscopy in the past 5 years was 40%. Several demographic factors were associated with screening practice. For example, participants 60 years and older, those who had a family history of cancer, those who where employed, and who had health insurance were more likely to get screened (p<.05). Additionally, there were differences in barriers to colorectal screening by geographic region. For example, participants in Memphis were more likely to report transportation issues and difficulty finding child or elderly care as a screening barrier compared to participants in Nashville and Chattanooga (p<.05).

Discussion: Demographic differences in the likelihood of screening and regional differences in barriers to getting screened needs to be incorporated into educational interventions aimed at improving colorectal cancer screening and knowledge.