Colorectal cancer knowledge, perceptions, and behaviors in African Americans

Disparities in healthcare among racial and ethnic minorities are associated with poor outcomes. African Americans have the highest incidence of colorectal cancer (CRC) among all racial groups. Using a nonrandom sample of 100 African American men and women, 50 years of age and older, the authors explored CRC knowledge, perceptions, and screening behaviors of African American men and women who resided or worked in an urban low-income housing residence. The extent to which screening may be attributed to demographic, sociopsychological, and structural variables was also investigated. Respondents demonstrated inadequate knowledge of CRC, with a significant difference in mean scores between males and females. Self-report of participation in CRC screening was above the national average, with almost half of the sample reporting fecal occult blood home kit use and more than half of the sample reporting completion of sigmoid and colonoscopy exams and double contrast barium enema exam. A majority perceived CRC as a threat. A very high percentage perceived numerous benefits to CRC screening in preventing CRC susceptibility. Perceived barriers of nearly half of the sample included screening may be painful and afraid to find out something is wrong if I have CRC screening, while more than half did not know how to schedule screening. Barriers and threat were correlated with grade school education. Barriers were negatively correlated with secondary education and post-secondary education and moderately correlated with threat. Predictor variables found in the Health Belief Model accounted for a significant amount of the variance in screening behavior, barriers, and threat. Older African American men and women need more information about CRC in order to increase their awareness of CRC and the importance of screening. There is a need to educate healthcare professionals about the causes, prevention, and detection of CRC and the importance of screening.