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Colon Cancer Worry in Appalachia

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Abstract

Appalachia has a higher incidence of and mortality from colon cancer (CC) than other regions of the United States; thus, it is important to know the potential impact of elevated risk on cancer worry. Guided by the Self-regulation model, we investigated the association of demographic, cultural (e.g., fatalism, religious commitment), and psychological factors (e.g., perceived risk, general mood) with CC worry among a sample of Appalachian women. A mixed method design was utilized. Appalachian women completed surveys in the quantitative section (n = 134) and semi-structured interviews in the qualitative section (n = 24). Logistic regression was employed to calculate odds ratios (OR) for quantitative data, and immersion/crystallization was utilized to analyze qualitative data. In the quantitative section, 45% of the participants expressed some degree of CC worry. CC worry was associated with higher than high school education (OR 3.63), absolute perceived risk for CC (OR 5.82), high anxiety (OR 4.68), and awareness of easy access (OR 3.98) or difficult access (OR 3.18) to health care specialists as compared to not being aware of the access. there was no association between CC worry and adherence to CC screening guidelines. The qualitative section revealed fear, disengagement, depression, shock, and worry. Additionally, embarrassment, discomfort, and worry were reported with regard to CC screening. Fears included having to wear a colostomy bag and being a burden on family. CC worry was common in Appalachians and associated with higher perceptions of risk for CC and general anxiety, but not with adherence to screening guidelines. The mixed method design allowed for enhanced understanding of CC-related feelings, especially CC worry, including social/contextual fears.

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Acknowledgements

We thank West Virginia Clinical and Translational Science Institute for statistical assistance it provided in preparing this manuscript.

Funding

This research study was funded by the National Cancer Institute [Principal Investigator of Supplement to Promote Diversity in Health Research: Dr. Kimberly Kelly, Supplement PI. (5P50-CA105632-02) (Paskett, Center PI)].

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Authors and Affiliations

  1. Department of Pharmacy Practice, Administration, & Research, Marshall University, Coon Education Building, One John Marshall Drive, Huntington, WV, 25755, USA

    Omar F. Attarabeen

  2. Department of Pharmaceutical Systems & Policy, Robert C. Byrd Health Sciences Center (North), West Virginia University, P.O. Box 9510, Morgantown, WV, 26506-9510, USA

    Usha Sambamoorthi & Kimberly M. Kelly

  3. Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Room 2220, Life Sciences Building, P. O. Box 6040, Morgantown, WV, 26506, USA

    Kevin T. Larkin

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  1. Omar F. Attarabeen
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  2. Usha Sambamoorthi
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  4. Kimberly M. Kelly
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Correspondence to Kimberly M. Kelly.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all participants in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration, as revised in 2000.

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Attarabeen, O.F., Sambamoorthi, U., Larkin, K.T. et al. Colon Cancer Worry in Appalachia. J Community Health 43, 79–88 (2018). https://doi.org/10.1007/s10900-017-0390-z

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  • DOI: https://doi.org/10.1007/s10900-017-0390-z

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