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Colorectal screening patterns and perceptions of risk among African-American users of a community health center

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Abstract

This study investigated risk perceptions and screening patterns for colorectal cancer among predominately low-income African-Americans age 50 and older who used a community health center. The majority of respondents either rated their risk as below average (36%) or did not know their risk (37%) for colorectal cancer. Individuals who provided a risk estimate versus those who did not know their risk were younger and held more accurate beliefs about colorectal cancer. Attributions of perceived risk best distinguished respondents who evaluated their risk to be below average versus average and above average. Compared to respondents who could not explain their risk, those who provided psychological, personal action, and heredity causes were more likely to view their risk as below average than average or above average. In comparison to national norms, these subjects reported higher frequencies of ever having had a digital rectal exam (DRE, 90%), fecal occult blood test (FOBT, 75%) and sigmoidoscopy (SIG, 33%). Moreover, 63%, 53%, and 81% reported their most recent screening for DRE, FOBT, and SIG, respectively, in accordance with ACS and NCI recommended guidelines. However, a subsequent medical audit failed to confirm these self-reports. These results suggest that: 1) educational efforts are needed to enhance knowledge and accuracy of risk perceptions for colorectal cancer; 2) further studies on attributions of risk are needed that may prove useful for developing intervention programs, and 3) studies need to interpret self-report data for colorectal cancer with caution.

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Authors and Affiliations

  1. Duke University Medical Center, 2200 West Main Street, Suite B-150, First Union Plaza, 27705, Durham, NC

    Isaac M. Lipkus PhD (Assistant Research Professor of Psychiatry), Barbara K. Rimer DrPH (Director of the Cancer Detection, Prevention, and Control Research Program and Professor of Family and Community Medicine), Pauline R. Lyna MPH (Clinical Research Analyst at the Comprehensive Cancer Center), Archana A. Pradhan MA (medical student), Mark Conaway PhD (Associate Professor of Biostatistics) & C. T. Woods-Powell MA (Clinical Researcher at the Comprehensive Cancer Center)

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  1. Isaac M. Lipkus PhD
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  2. Barbara K. Rimer DrPH
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  3. Pauline R. Lyna MPH
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  4. Archana A. Pradhan MA
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  5. Mark Conaway PhD
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  6. C. T. Woods-Powell MA
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Additional information

We thank Emma Morton and Jenny Terrenoire for their helpful comments on an earlier version of this manuscript, and David Ransohoff for his help in creating the study questionnaire. This study was supported by NIH grant 1R01-CA-59734-03.

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Lipkus, I.M., Rimer, B.K., Lyna, P.R. et al. Colorectal screening patterns and perceptions of risk among African-American users of a community health center. J Community Health 21, 409–427 (1996). https://doi.org/10.1007/BF01702602

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