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Adherence to Physician Recommendation to Colorectal Cancer Screening Colonoscopy Among Hispanics

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ABSTRACT

BACKGROUND

Colorectal cancer (CRC) is the second most commonly diagnosed cancer among Hispanics in the United States (US), yet the use of CRC screening is low in this population. Physician recommendation has consistently shown to improve CRC screening.

OBJECTIVE

To identify the characteristics of Hispanic patients who adhere or do not adhere to their physician’s recommendation to have a screening colonoscopy.

DESIGN

A cross-sectional study featuring face-to-face interviews by culturally matched interviewers was conducted in primary healthcare clinics and community centers in New York City.

PARTICIPANTS

Four hundred Hispanic men and women aged 50 or older, at average risk for CRC, were interviewed. Two hundred and eighty (70%) reported receipt of a physician’s recommendation for screening colonoscopy and are included in this study.

MAIN MEASURES

Dependent variable: self report of having had screening colonoscopy. Independent variables: sociodemographics, healthcare and health promotion factors.

KEY RESULTS

Of the 280 participants, 25% did not adhere to their physician’s recommendation. Factors found to be associated with non-adherence were younger age, being born in the US, preference for completing interviews in English, higher acculturation, and greater reported fear of colonoscopy testing. The source of colonoscopy recommendation (whether it came from their usual healthcare provider or not, and whether it occurred in a community or academic healthcare facility) for CRC screening was not associated with adherence.

CONCLUSIONS

This study indicates that potentially identifiable subgroups of Hispanics may be less likely to follow their physician recommendation to have a screening colonoscopy and thus may decrease their likelihood of an early diagnosis and prompt treatment. Raising physicians’ awareness to such patients’ characteristics could help them anticipate patients who may be less adherent and who may need additional encouragement to undergo screening colonoscopy.

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Acknowledgements

The authors would like to extend thanks to the study participants, and the study sites, the East Harlem community, and the East Harlem Partnership for Cancer Awareness’ Community Advisory Board for their insight and support. The authors would also like to thank Simay Gokbayrak for her assistance throughout the writing of this paper. This project was supported by Grant No. R21 CA119016 from the National Institutes of Health. A presentation on the results from the parent study included some of these findings with a smaller sample size (prior to data completion) entitled: “Patient–Provider Interaction Effects on Colorectal Cancer Screening among Urban Hispanics” presented at the Public Health Association of New York City’s (PHANYC) Fourth Annual Student Conference, New York, USA on June 14th, 2009.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Department of Surgery/Division of Surgical Oncology, Mount Sinai School of Medicine, New York, NY, USA

    Ghalib Jibara MD, MPH

  2. Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA

    Lina Jandorf MA & Katherine N. DuHamel PhD

  3. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Monica B. Fodera MA & Katherine N. DuHamel PhD

Authors
  1. Ghalib Jibara MD, MPH
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  2. Lina Jandorf MA
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  3. Monica B. Fodera MA
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  4. Katherine N. DuHamel PhD
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Correspondence to Lina Jandorf MA.

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Jibara, G., Jandorf, L., Fodera, M.B. et al. Adherence to Physician Recommendation to Colorectal Cancer Screening Colonoscopy Among Hispanics. J GEN INTERN MED 26, 1124–1130 (2011). https://doi.org/10.1007/s11606-011-1727-4

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  • DOI: https://doi.org/10.1007/s11606-011-1727-4

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