Misconceptions in colorectal cancer among a community-based population and CRC screening adherence.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 6578-6578
Author(s):  
Thomas Guerrero ◽  
Mobeen Rehman ◽  
Mary Roberts ◽  
Joseph Diaz
Keyword(s):  
Colorectal Cancer ◽  
Community Based ◽  
Crc Screening ◽  
Screening Adherence

scholarly journals Effect of Neighborhood and Individual-Level Socioeconomic Factors on Colorectal Cancer Screening Adherence

2021 ◽  
Vol 18 (9) ◽  
pp. 4398
Author(s):  
Kiara N. Mayhand ◽  
Elizabeth A. Handorf ◽  
Angel G. Ortiz ◽  
Evelyn T. Gonzalez ◽  
Amie Devlin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Study Participant ◽  
Socioeconomic Indicators ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Total Study Population ◽  
Screening Guidelines ◽  
Individual Level ◽  
Crc Screening ◽  
Screening Adherence

Despite the effectiveness of screenings in reducing colorectal cancer (CRC) mortality, ~25% of US adults do not adhere to screening guidelines. Prior studies associate socioeconomic status (SES) with low screening adherence and suggest that neighborhood deprivation can influence CRC outcomes. We comprehensively investigated the effect of neighborhood SES circumstances (nSES), individual SES, and race/ethnicity on adherence to CRC screening in a multiethnic cross-sectional study. Participant surveys assessing 32 individual-level socioeconomic and healthcare access measures were administered from 2017 to 2018. Participant data were joined with nine nSES measures from the US Census at the census tract level. Univariate, LASSO, and multivariable mixed-effect logistic regression models were used for variable reduction and evaluation of associations. The total study population included 526 participants aged 50–85; 29% of participants were non-adherent. In the final multivariable model, age (p = 0.02) and Non-Hispanic Black race (p = 0.02) were associated with higher odds of adherence. Factors associated with lower adherence were home rental (vs. ownership) (p = 0.003), perception of low healthcare quality (p = 0.006), no routine checkup within two years (p = 0.002), perceived discrimination (p = 0.02), and nSES deprivation (p = 0.02). After comprehensive variable methods were applied, socioeconomic indicators at the neighborhood and individual level were found to contribute to low CRC screening adherence.

scholarly journals Barriers and Facilitators to Colorectal Cancer Screening Within a Hispanic Population

2018 ◽  
Vol 17 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Theresa L. Byrd ◽  
Jessica Calderón-Mora ◽  
Rebekah Salaiz ◽  
Navkiran K. Shokar
Keyword(s):  
Colorectal Cancer ◽  
Focus Groups ◽  
Screening Program ◽  
El Paso ◽  
Barriers And Facilitators ◽  
Hispanic Population ◽  
Community Based ◽  
Crc Screening ◽  
Predominantly Hispanic ◽  
9Th Grade

Introduction: Colorectal cancer (CRC) is the third leading cancer cause of death among US Hispanics. CRC screening among the Hispanic population is lower compared with non-Hispanic Whites. Method: The purpose of this qualitative, exploratory study was to better understand the barriers and facilitators of CRC screening and preference for stool-based testing collection methods among the predominantly Hispanic population of El Paso, Texas. Nine focus groups were conducted by a trained bilingual facilitator with a moderator guide informed by the literature. Transcripts of the focus groups were entered into qualitative analysis software and a thematic network was developed. Results: Fifty-six participants were recruited: average age was 68.5 years, 58.9% were female, 98.2% were Hispanic, 87.5% had an annual income of less than $20,000, 58.9% had 9th grade education or less, 12.5% had a discount program, and 5.4% had no insurance. Barriers to CRC screening included cost, fear, and embarrassment. Facilitators to screening included in-person health education and physician recommendation. Participants preferred the hygienic nature of a stool test collected with a brush and bottle. Conclusion: Overall, there was a lack of knowledge regarding CRC and significant barriers to CRC screening. A community-based CRC screening program was subsequently developed from our findings.

scholarly journals Tailored message interventions versus typical messages for increasing participation in colorectal cancer screening among a non-adherent population: A randomized controlled trial

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Kei Hirai ◽  
Yoshiki Ishikawa ◽  
Jun Fukuyoshi ◽  
Akio Yonekura ◽  
Kazuhiro Harada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trial ◽  
Screening Program ◽  
Controlled Trial ◽  
Baseline Survey ◽  
Attendance Rates ◽  
Community Based ◽  
Crc Screening ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background The purpose of this study was to examine the effectiveness and cost-efficiency of a tailored message intervention compared with a non-tailored message intervention for increasing colorectal cancer (CRC) screening rates among a non-adherent population, in a community-based client reminder program. Methods After a baseline survey for psychological segmentation, 2140 eligible individuals were randomly assigned either to a group with a tailored matched-message condition (N = 356), a group with a non-tailored unmatched-message condition (N = 355), or to two control groups, one using a typical message with a professional design (N = 717) and one without a professional design (N = 712). The main outcome measure was attendance rates in a community-organized CRC screening program within five months of receiving a print reminder. Results There was a significant difference in fecal occult blood test (FOBT) attendance rates at follow-up assessments between the tailored matched-message condition (14.0 %) and the control (9.9 %; OR = 1.48, p = 0.026), while there was no significant difference between the unmatched-message condition (11.0 %) and the control (OR = 1.12, p = 0.558), and between the matched-message condition and the unmatched-message condition (OR = 1.32, p = 0.219). The cost of a one-person increase in FOBT screening was 3,740 JPY for the tailored matched-message condition, while it was 2,747 JPY for the control. Conclusions A tailored-message intervention for segmented individuals designed to increase CRC screening rates in a community-based client reminder program was significantly effective compared to a usual reminder, but not more effective than an unmatched message in a randomized controlled trial, and was not sufficiently effective to highlight its value from a cost perspective. Therefore, the tailored intervention including target segmentation needs to be improved for future implementation in a CRC screening program for a non-adherent population. Trial registration UMIN Clinical Trials Registry UMIN000004384. Date of Registration: March 2011.

scholarly journals Assessing Colorectal Cancer Screening Adherence of Medicare Fee-for-Service Beneficiaries Age 76 to 95 Years

2016 ◽  
Vol 12 (6) ◽  
pp. e670-e680 ◽  
Author(s):  
John Bian ◽  
Charles Bennett ◽  
Gregory Cooper ◽  
Alessandra D'Alfonso ◽  
Deborah Fisher ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Odds Ratio ◽  
Patient Adherence ◽  
Adherence Rate ◽  
Average Risk ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Crc Screening ◽  
The Status ◽  
Screening Adherence

Introduction: There are concerns about potential overuse of colorectal cancer (CRC) screening services among average-risk individuals older than age 75 years. Materials and Methods: Using a 5% random noncancer sample of Medicare beneficiaries who resided in the SEER areas, we examined rates of CRC screening adherence, defined by the Medicare coverage policy, among average-risk fee-for-service beneficiaries age 76 to 95 years from 2002 to 2010. The two outcomes are the status of overall CRC screening adherence, and the status of adherence to colonoscopy (v other modalities) conditional on patient adherence. Results: Overall CRC screening adherence rates of Medicare beneficiaries age 76 to 95 years increased from 13.0% to 21.4% from 2002 to 2010. In 2002, 2.2% of beneficiaries were adherent to colonoscopy, and 10.7%, by other modalities; the corresponding rates were 19.5% and 1.9%, respectively, in 2010. Specifically, rates of adherence to colonoscopy were 1.1% for those age 86 to 90 years and almost nil for those age 91 to 95 years in 2002, but the rates became 13.5% and 8.2%, respectively, in 2010. Compared with white beneficiaries, black beneficiaries age 76 to 95 years had a 7-percentage-point lower adherence rate. However, overall adherence rates among blacks increased by 168.6% from 2002 to 2010, whereas rates among whites increased by 63.0%. Logistic regressions showed that blacks age 86 to 95 years were less likely than whites to be adherent (odds ratio, 0.56; 95% CI, 0.47 to 0.59) but were more likely to be adherent to colonoscopy (odds ratio, 2.34; 95% CI, 1.47 to 3.91). Conclusion: High proportions of average-risk Medicare fee-for-service beneficiaries screened by colonoscopy may represent opportunities for improving appropriateness and allocative efficiency of CRC screening by Medicare.

scholarly journals Colorectal cancer knowledge and screening adherence among low-income Hispanic employees

2019 ◽  
Vol 34 (4) ◽  
pp. 400-414
Author(s):  
Judy Y Ou ◽  
Echo L Warner ◽  
Gina E Nam ◽  
Laura Martel ◽  
Sara Carbajal-Salisbury ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Low Income ◽  
Educational Interventions ◽  
Manual Labor ◽  
Cancer Knowledge ◽  
Post Intervention ◽  
Chi Square ◽  
Crc Screening ◽  
Hispanic Workers ◽  
Screening Adherence

Abstract Hispanics have the lowest colorectal cancer (CRC) screening rates of all racial/ethnic groups and comprise the largest proportion of low-income manual laborers in the nation. We partnered with businesses to implement a community health worker (CHW)-led intervention among Hispanic workers in service-related and manual labor occupations, which often pay low wages and do not provide health insurance. CHWs measured knowledge, screening adherence and perceptions of CRC risk before and after educational interventions via interview. CHWs provided fecal immunochemical tests (FITs) to participants aged ≥50 years. Chi-square tests and logistic regression identified pre-intervention predictors of CRC knowledge of all participants and adherence among eligible participants. Adherence among participants increased from 40% (n = 307) pre-intervention to 66% post-intervention. Knowledge about CRC was associated with age ≥50 years (OR = 8.90 [95% CI = 2.61–30.35]; ref = 18–30) and perceived personal risk for CRC (Likely, OR = 3.06 [95% CI = 1.40–6.67]; ref = Not likely). Insurance status was associated with screening adherence pre-intervention (OR = 3.00 [95% CI 1.10–8.12]; ref = No insurance). Improvement in adherence post-intervention was associated with income between $25 000 and ≥$55 000 (OR = 8.49 [95% CI 1.49–48.32]; ref = $5000–<$10 000). Community-based health programs can improve CRC screening adherence among Hispanic workers in service-related and manual labor positions, but lowest-income workers may need additional support.

scholarly journals Development of a Group-Based Community Health Worker Intervention to Increase Colorectal Cancer Screening Among Latinos

2020 ◽  
pp. 154041532092356
Author(s):  
C. L. De La Torre ◽  
J. N. Dumbauld ◽  
J. Haughton ◽  
S. Gupta ◽  
J. Nodora ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Focus Groups ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Community Advisory Board ◽  
Community Based ◽  
Latino Men ◽  
Crc Screening

Introduction: Latinos are at higher risk of colorectal cancer (CRC) mortality than non-Hispanic Whites due, in part, to disparities in cancer screening. There is a need to evaluate community-based CRC interventions as they may reach underinsured communities and those at highest risk for CRC. This article describes the development of a group-based CRC intervention ( Juntos contra el Cancer). Method: Purposive sampling was used to recruit Latino men and women aged 50 to 75 years not-up-to-date with CRC screening. The development of the intervention was guided by the socioecologic framework, a community needs assessment, literature reviews, five focus groups ( n = 39) from the target community and feedback from a Community Advisory Board. Results: Findings from focus groups suggested that a group-based, promotor or community health worker (CHW) led, cancer prevention education with linkages to care would address barriers to CRC screening. Conclusion: Development of community-based CRC screening interventions should be informed by early and sustained community engagement. Interventions led by CHWs with linkages to care are feasible and can reach populations not connected to health care settings.

scholarly journals Screening Recommendation Adherence Among First-Degree Relatives of People With Colorectal Cancer

2021 ◽  
Author(s):  
Mark A Fiala
Keyword(s):  
Colorectal Cancer ◽  
Crc Screening ◽  
First Degree Relatives ◽  
Hispanic Community ◽  
The Us ◽  
History Of ◽  
Screening Adherence ◽  
Interview Survey ◽  
Multivariable Models ◽  
Nationally Representative

Abstract Purpose: To determine what factors are associated with colorectal cancer (CRC) screening adherence among first-degree relatives (FDRs) of people with CRC.Methods: The study used data from the 2015 National Health Interview Survey, a nationally representative survey in the US. Self-reported CRC screening rates were compared between FDRs and their peers without a family history of CRC. Participants were considered to be adherent if they had undergone any of the following: fecal immonchemical test within the prior 1 year, sigmoidscopy or computed tomography colongraphy within 5 years, or colonoscopy within 10 years. Multivariable models of CRC screening adherence were created for both cohorts and the results compared. Results: The analysis included 11,381 people age 50-75 at time of survey. Overall, 62% of participants were adherent to screening recommendations. FDR of people with CRC were more likely to be adherent (76% compared to 61%, p < 0.001). In the multivariable models, a FDR with CRC was associated with an 86% increase in odds of being adherent to recommendations (aOR 1.86; 95% CI 1.59-2.59). Race, ethnicity, and socioeconomic variables were all associated with adherence. Models were largely similar between FDRs of people with CRC and the general public. Conclusions: Approximately one-quarter of FDRs of people with CRC are not adherent to screening recommendations. Further outreach is needed for members of minority races and the Hispanic community and additional efforts are needed to increase the accessibility of CRC screening for those with more limited finances and the uninsured.

scholarly journals Multilevel Pathways of Colorectal Cancer Screening Among Low-Income Vietnamese Americans: A Structural Equation Modeling Analysis

2021 ◽  
Vol 28 ◽  
pp. 107327482110110
Author(s):  
Grace X. Ma ◽  
Lin Zhu ◽  
Timmy R. Lin ◽  
Yin Tan ◽  
Phuong Do
Keyword(s):  
Health Beliefs ◽  
Low Income ◽  
Self Efficacy ◽  
Limited English Proficiency ◽  
Structural Equation ◽  
Vietnamese Americans ◽  
Equation Modeling ◽  
Community Based ◽  
Related Factors ◽  
Crc Screening

Background: Colorectal cancer (CRC) disproportionately affects Vietnamese Americans, especially those with low income and were born outside of the United States. CRC screening tests are crucial for prevention and early detection. Despite the availability of noninvasive, simple-to-conduct tests, CRC screening rates in Asian Americans, particularly Vietnamese Americans, remain suboptimal. The purpose of this study was to evaluate the interplay of multilevel factors – individual, interpersonal, and community – on CRC screening behaviors among low-income Vietnamese Americans with limited English proficiency. Methods: This study is based on the Sociocultural Health Behavior Model, a research-based model that incorporates 6 factors associated with decision-making and health-seeking behaviors that result in health care utilization. Using a community-based participatory research approach, we recruited 801 Vietnamese Americans from community-based organizations. We administered a survey to collect information on sociodemographic characteristics, health-related factors, and CRC screening-related factors. We used structural equation modeling (SEM) to identify direct and indirect predictors of lifetime CRC screening. Results: Bivariate analysis revealed that a greater number of respondents who never screened for CRC reported limited English proficiency, fewer years of US residency, and lower self-efficacy related to CRC screening. The SEM model identified self-efficacy (coefficient = 0.092, P < .01) as the only direct predictor of lifetime CRC screening. Educational attainment (coefficient = 0.13, P < .01) and health beliefs (coefficient = 0.040, P < .001) had a modest significant positive relationship with self-efficacy. Health beliefs (coefficient = 0.13, P < .001) and educational attainment (coefficient = 0.16, P < .01) had significant positive relationships with CRC knowledge. Conclusions: To increase CRC screening uptake in medically underserved Vietnamese American populations, public health interventions should aim to increase community members’ confidence in their abilities to screen for CRC and to navigate associated processes, including screening preparation, discussions with doctors, and emotional complications.

scholarly journals National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1129
Author(s):  
Audrius Dulskas ◽  
Tomas Poskus ◽  
Inga Kildusiene ◽  
Ausvydas Patasius ◽  
Rokas Stulpinas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Assurance ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Histopathological Examination ◽  
Insurance Fund ◽  
Crc Screening ◽  
Cancer Screening Program ◽  
The Impact

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.

scholarly journals Colorectal cancer screening using a stool DNA-based SDC2 methylation test: a multicenter, prospective trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Woo Kim ◽  
Hyunjin Kim ◽  
Hyoung Rae Kim ◽  
Bong-Hyeon Kye ◽  
Hyung Jin Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Early Detection ◽  
Prospective Trial ◽  
Screening Colonoscopy ◽  
Quantitative Detection ◽  
Screening Programs ◽  
Crc Screening ◽  
Stool Dna ◽  
Dna 2

Abstract Background Prevention and early detection of colorectal cancer (CRC) is a global priority, with many countries conducting population-based CRC screening programs. Although colonoscopy is the most accurate diagnostic method for early CRC detection, adherence remains low because of its invasiveness and the need for extensive bowel preparation. Non-invasive fecal occult blood tests or fecal immunochemical tests are available; however, their sensitivity is relatively low. Syndecan-2 (SDC2) is a stool-based DNA methylation marker used for early detection of CRC. Using the EarlyTect™-Colon Cancer test, the sensitivity and specificity of SDC2 methylation in stool DNA for detecting CRC were previously demonstrated to be greater than 90%. Therefore, a larger trial to validate its use for CRC screening in asymptomatic populations is now required. Methods All participants will collect their stool (at least 20 g) before undergoing screening colonoscopy. The samples will be sent to a central laboratory for analysis. Stool DNA will be isolated using a GT Stool DNA Extraction kit, according to the manufacturer’s protocol. Before performing the methylation test, stool DNA (2 µg per reaction) will be treated with bisulfite, according to manufacturer’s instructions. SDC2 and COL2A1 control reactions will be performed in a single tube. The SDC2 methylation test will be performed using an AB 7500 Fast Real-time PCR system. CT values will be calculated using the 7500 software accompanying the instrument. Results from the EarlyTect™-Colon Cancer test will be compared against those obtained from colonoscopy and any corresponding diagnostic histopathology from clinically significant biopsied or subsequently excised lesions. Based on these results, participants will be divided into three groups: CRC, polyp, and negative. The following clinical data will be recorded for the participants: sex, age, colonoscopy results, and clinical stage (for CRC cases). Discussion This trial investigates the clinical performance of a device that allows quantitative detection of a single DNA marker, SDC2 methylation, in human stool DNA in asymptomatic populations. The results of this trial are expected to be beneficial for CRC screening and may help make colonoscopy a selective procedure used only in populations with a high risk of CRC. Trial registration: This trial (NCT04304131) was registered at ClinicalTrials.gov on March 11, 2020 and is available at https://clinicaltrials.gov/ct2/show/NCT04304131?cond=NCT04304131&draw=2&rank=1.

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