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Colorectal cancer screening among Latinos from U.S. cities along the Texas–Mexico border

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Abstract

Colorectal cancer (CRC) screening rates are comparatively low for U.S. Hispanics. To learn more about the factors influencing CRC screening among Hispanics living along the U.S.–Mexico border, 12 focus groups were conducted with Hispanic men and women aged 50 years and older in three Texas counties; Cameron County (Brownsville), Webb County (Laredo), and El Paso County, (El Paso). The focus group guide contained questions about health care behavior, knowledge about CRC, experiences with cancer, and factors that influence CRC screening. A total of 92 individuals participated with the majority aged 50–69 (75%). Twenty percent were born in the United States and 51% had lived in the United States for more than 20 years. Participants had low levels of education, income, and insurance coverage. The analysis revealed several overarching and contextual themes relating to knowledge, attitudes, beliefs, and emotions about cancer and CRC screening. A prevalent theme that emerged from all groups was frustration and a lack of confidence in the U.S. healthcare system. Few participants had been advised by their providers to obtain CRC screening. Lack of patient knowledge about colorectal cancer and screening appeared to be a critical factor influencing screening. Themes about death and pain due to cancer were prevalent as were cultural factors such as machismo and embarrassment. System level barriers such as cost, medical insurance and transportation also impacted screening. These findings suggest that strategies are needed to educate Hispanic residents of border communities about CRC and to motivate them to undergo CRC screening.

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References

  1. Stefanidis D, Pollock BH, Miranda J, Wong A, Sharkey FE, Rousseau DL et al (2006) Colorectal cancer in Hispanics: a population at risk for earlier onset, advanced disease, and decreased survival. Am J Clin Oncol 29(2):123–126

    Article  PubMed  Google Scholar 

  2. Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch TDoSHS. Cancer incidence data (2000 August) [cited 2006 Dec 19]; Available from: URL: http://www.dshs.state.tx.us/tcr/default.shtm

  3. Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ et al (2007) SEER cancer statistics review, 1975–2004, Table I-26; Available from: URL: http://www.seer.cancer.gov/csr/1975_2004/

  4. Singh H, Turner D, Xue L, Targownik LE, Bernstein CN (2006) Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. JAMA 295(20):2366–2373

    Article  PubMed  CAS  Google Scholar 

  5. Mandel JS, Church TR, Bond JH, Ederer F, Geisser MS, Mongin SJ et al (2000) The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med 343(22):1603–1607

    Article  PubMed  CAS  Google Scholar 

  6. U.S. Preventive Services Task Force (2002) Guide to clinical preventive services, 2nd/3rd edn. U.S. Government Printing Office, Washington, DC

  7. Howe HL, Wu X, Ries LA, Cokkinides V, Ahmed F, Jemal A et al (2006) Annual report to the nation on the status of cancer, 1975–2003, featuring cancer among U.S. Hispanic/Latino populations. Cancer 107(8):1711–1742

    Article  PubMed  Google Scholar 

  8. Texas Department of State Health Services (2007) Texas behavioral risk factor surveillance system [cited 2007 July 1]; Available from: URL: http://www.dshs.state.tx.us/chs/brfss/query/brfss_form.shtm

  9. Honda K, Kagawa-Singer M (2006) Cognitive mediators linking social support networks to colorectal cancer screening adherence. J Behav Med 29(5):449–460

    Article  PubMed  Google Scholar 

  10. Costanza ME, Luckmann R, Stoddard AM, Avrunin JS, White MJ, Stark JR et al (2005) Applying a stage model of behavior change to colon cancer screening. Prev Med 41(3–4):707–719

    Article  PubMed  Google Scholar 

  11. Brawarsky P, Brooks DR, Mucci LA (2003) Correlates of colorectal cancer testing in Massachusetts men and women. Prev Med 36(6):659–668

    Article  PubMed  CAS  Google Scholar 

  12. Gorin SS, Heck JE (2005) Cancer screening among Latino subgroups in the United States. Prev Med 40(5):515–526

    Article  PubMed  Google Scholar 

  13. Zapka JG, Puleo E, Vickers-Lahti M, Luckmann R (2002) Healthcare system factors and colorectal cancer screening. Am J Prev Med 23(1):28–35

    Article  PubMed  Google Scholar 

  14. Cokkinides VE, Chao A, Smith RA, Vernon SW, Thun MJ (2003) Correlates of underutilization of colorectal cancer screening among U.S. adults, age 50 years and older. Prev Med 36(1):85–91

    Article  PubMed  Google Scholar 

  15. Watts BG, Vernon SW, Myers R, Tilley BC (2003) Intention to be screened over time for colorectal cancer in male automotive workers. Cancer Epidemiol Biomarkers Prev 12:339–349

    PubMed  Google Scholar 

  16. Klabunde CN, Vernon SW, Nadel MR, Breen N, Seeff LC, Brown ML (2005) Barriers to colorectal cancer screening: a comparison of reports from primary care physicians and average-risk adults. Med Care 43(9):939–944

    Article  PubMed  Google Scholar 

  17. Janz NK, Wren PA, Schottenfeld D, Guire KE (2003) Colorectal cancer screening attitudes and behavior: a population-based study. Prev Med 37(6 Pt 1):627–634

    Article  PubMed  Google Scholar 

  18. Wei EK, Ryan CT, Dietrich AJ, Colditz GA (2005) Improving colorectal cancer screening by targeting office systems in primary care practices: disseminating research results into clinical practice. Arch Intern Med 165(6):661–666

    Article  PubMed  Google Scholar 

  19. Yepes-Rios M, Reimann JO, Talavera AC, Ruiz de Esparaza A, Talavera GA (2006) Colorectal cancer screening among Mexican Americans at a community clinic. Am J Prev Med 30(3):204–210

    Article  PubMed  Google Scholar 

  20. Brouse CH, Basch CE, Wolf RL, Shmukler C, Neugut AI, Shea S (2003) Barriers to colorectal cancer screening with fecal occult blood testing in a predominantly minority urban population: a qualitative study. Am J Public Health 93(8):1268–1271

    PubMed  Google Scholar 

  21. Bastani R, Gallardo NV, Maxwell AE (2001) Barriers to colorectal cancer screening among ethnically diverse high- and average-risk individuals. J Psychosoc Oncol 19(3–4):65–84

    Article  Google Scholar 

  22. Coronado GD, Farias A, Thompson B, Godina R, Oderkirk W (2006) Attitudes and beliefs about colorectal cancer among Mexican Americans in communities along the US–Mexico Border. Ethn Dis 6(2):421–427

    Google Scholar 

  23. Goodman MJ, Ogdie A, Kanamori MJ, Canar J, O’Malley AS (2006) Barriers and facilitators of colorectal cancer screening among Mid-Atlantic Latinos: focus group findings. Ethn Dis 16(1):255–261

    PubMed  Google Scholar 

  24. Royak-Schaler R, Blocker DE, Yali AM, Bynoe M, Briant KJ, Smith S (2004) Breast and colorectal cancer risk communication approaches with low-income African-American and Hispanic women: implications for healthcare providers. J Natl Med Assoc 96(5):598–608

    PubMed  Google Scholar 

  25. U.S. Census Bureau. State and County QuickFacts. 2006 June 8 [cited 6 A.D. Dec 18]; Available from: URL: http://www.quickfacts.census.gov/qfd/states/48000.html

  26. Bartholomew LK, Parcel GS, Kok G, Gottlieb NH (2006) Planning health promotion programs: an intervention mapping approach, 2nd edn. Jossey-Bass, San Francisco

    Google Scholar 

  27. Fishbein M (1995) Developing effective behavior change interventions: some lessons learned from behavioral research. In: Backer TE, David SL, Soucy G (eds) Reviewing the behavioral science knowledge base on technology transfer (NIDA Research Monograph No. 155, NIH Publications No. 95-4035). National Institute on Drug Abuse, Rockville, MD, pp 246–261

  28. Vernon SW, Meissner H, Klabunde C, Rimer BK, Ahnen DJ, Bastani R et al (2004) Measures for ascertaining use of colorectal cancer screening in behavioral, health services, and epidemiologic research. Cancer Epidemiol Biomarkers Prev 13(6):898–905

    PubMed  Google Scholar 

  29. Muhr T (2004) User’s manual for ATLAS.ti 5.0. ATLAS.ti Scientific Software Development GmbH, Berlin

    Google Scholar 

  30. Fernandez ME, Wippold R, Byrd T, Longoria J (2007) Use of folk healing and home remedies among Mexican Americans living in three cities along the TX–Mexico border. Ref Type: Unpublished work

  31. Weitzman ER, Zapka J, Estabrook B, Goins KV (2001) Risk and reluctance: understanding impediments to colorectal cancer screening. Prev Med 32(6):502–513

    Article  PubMed  CAS  Google Scholar 

  32. Davis TC, Dolan NC, Ferreira MR, Tomori C, Green KW, Sipler AM et al (2001) The role of inadequate health literacy skills in colorectal cancer screening. Cancer Invest 19(2):193–200

    Article  PubMed  CAS  Google Scholar 

  33. O’Malley AS, Gonzalez RM, Sheppard VB, Huerta E, Mandelblatt J (2003) Primary care cancer control interventions including Latinos: a review. Am J Prev Med 25(3):264–271

    Article  PubMed  Google Scholar 

  34. Coronado G, Farias A, Thompson B, Godina R, Oderkirk W (2006) Is being Hispanic a risk factor for non-insulin dependent diabetes mellitus (NIDDM)? Ethn Dis 16(12):421–427

    PubMed  Google Scholar 

  35. Walsh JM, Kaplan CP, Nguyen B, Gildengorin G, McPhee SJ, Perez-Stable EJ (2004) Barriers to colorectal cancer screening in Latino and Vietnamese Americans. Compared with non-Latino white Americans. J Gen Intern Med 19(2):156–166

    Article  PubMed  Google Scholar 

  36. Bastani R, Yabroff KR, Myers RE, Glenn B (2004) Interventions to improve follow-up of abnormal findings in cancer screening. Cancer 101(5 Suppl):1188–1200

    Article  PubMed  Google Scholar 

  37. Holmes-Rovner M, Williams GA, Hoppough S, Quillan L, Butler R, Given CW (2002) Colorectal cancer screening barriers in persons with low income. Cancer Pract 10(5):240–247

    Article  PubMed  Google Scholar 

  38. Lees KA, Wortley PM, Coughlin SS (2005) Comparison of racial/ethnic disparities in adult immunization and cancer screening. Am J Prev Med 29(5):404–411

    Article  PubMed  Google Scholar 

  39. Pollack LA, Blackman DK, Wilson KM, Seeff LC, Nadel MR (2006) Colorectal cancer test use among Hispanic and non-Hispanic U.S. populations. Prev Chronic Dis 3(2):A50

    PubMed  Google Scholar 

  40. Thompson B, Coronado G, Neuhouser M, Chen L (2005) Colorectal carcinoma screening among Hispanics and non-Hispanic whites in a rural setting. Cancer 103(12):2491–2498

    Article  PubMed  Google Scholar 

  41. Messer E (1987) The hot and cold in Mesoamerican indigenous and Hispanicized thought. Soc Sci Med 5(4):339–346

    Article  Google Scholar 

  42. Freeman HP (1989) Cancer in the socioeconomically disadvantaged. CA Cancer J Clin 39(5):266–288

    Article  PubMed  CAS  Google Scholar 

  43. Powe BD, Johnson A (1995) Fatalism as a barrier to cancer screening among African-Americans – philosophical-perspectives. J Religion Health 34(2):119–125

    Article  Google Scholar 

  44. Powe BD, Finnie R (2003) Cancer fatalism: the state of the science. Cancer Nurs 26(6):454–465

    Article  PubMed  Google Scholar 

  45. Straughan PT, Seow A (1998) Fatalism reconceptualized: a concept to predict health screening behavior. J Gender Culture Health 3(2):85–100

    Article  Google Scholar 

  46. Sobralske MC (2006) Health care seeking among Mexican American men. J Transcult Nurs 17(2):129–138

    Article  PubMed  Google Scholar 

  47. Sobralske M (2006) Machismo sustains health and illness beliefs of Mexican American men. J Am Acad Nurse Pract 18(8):348–350

    Article  PubMed  Google Scholar 

  48. Galanti GA (2003) The Hispanic family and male–female relationships: an overview. J Transcult Nurs 14(3):180–185

    Article  PubMed  Google Scholar 

  49. Coughlin SS, Costanza ME, Fernandez ME, Glanz K, Lee JW, Smith SA et al (2006) CDC-funded intervention research aimed at promoting colorectal cancer screening in communities. Cancer 107(5 Suppl):1196–1204

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was funded by cooperative agreements (CDC PRC SIP 2-02U48 CCU6009653, CDC PRC SIP 16-04U48 CCU6009653, CDC PRC SIP 18-04U48 DCCU6009653). Dr. Vernon was supported by NCI CA97263 and CDC PRC SIP 19-04U48 DP000057. Dr. Bains was supported by NCI Grant U56-CA0999038.

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Correspondence to Maria E. Fernandez.

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The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention.

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Fernandez, M.E., Wippold, R., Torres-Vigil, I. et al. Colorectal cancer screening among Latinos from U.S. cities along the Texas–Mexico border. Cancer Causes Control 19, 195–206 (2008). https://doi.org/10.1007/s10552-007-9085-6

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  • DOI: https://doi.org/10.1007/s10552-007-9085-6

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