| Learning Objective #1: describe three barriers to colorectal cancer screening in African Americans | |||
| Learning Objective #2: describe the potential impact of provider recommendation in increasing colorectal cancer screening rates in underserved populations. |
Methods. Using the Biopsychosocial Model framework, forward and backward stepwise logistic regression analyses were done using data from 580 AA participants in the 2002 Maryland Cancer Survey. Social (education, employment, insurance, access to HCP, and HCP recommendation of fecal occult blood test [FOBT] and/or sigmoidoscopy/colonoscopy); biological (age, gender, CRC family history); and behavioral (e.g. mammogram and prostate specific antigen [PSA] screening history, activity level) predictors of timely CRC screening were evaluated.
Results. HCP recommendations of FOBT (OR 11.90, 95% CI: 6.84, 20.71, p<.001) and sigmoidoscopy/colonscopy (OR 7.06, 95% CI 4.11, 12.14, p<.001) predicted screening in subjects without family histories of CRC (n=473). Those with family histories of CRC (n=86) who received provider recommendations of sigmoidoscopy/colonscopy were over 24 times (95% CI 5.30, 111.34, p<.001) more likely to have timely CRC screening. Behaviors that predicted CRC screening for individuals without family histories were moderate/vigorous activity (OR 1.70, 95% CI: 1.02, 2.82, p<.01), and PSA screening (OR 2.81, 95% CI 1.01, 7.81, p<.01). Those with family histories who engaged in vigorous physical activity were 5.21 times (95% CI: 1.09, 24.88, p<.001) more likely to have obtained timely CRC screening.
Conclusions. HCP recommendations strongly predicted CRC screening for AAs with and without family histories of CRC. However, provider rationale for recommending particular types of CRC testing and factors associated with patient adherence to recommendations were beyond the scope of this study, warranting further investigation.