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Reluctance to Screening Colonoscopy in Arab Americans: A Community Based Observational Study

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Abstract

To explore compliance of Arab-Americans to colorectal cancer (CRC) screening and identify the barriers for non-compliance. An observational community based study. Arab-American Friday prayer attendees’ ≥50 years in three mosques in Dearborn, MI volunteered. Demographics, health insurance status, screening history, availability of a primary care physician (PCP) and the ability to communicate in Arabic were inquired. The responses were compared using a student t test between respondents who have had CRC screening with colonoscopy and those who have not had any screening tests. A p value of 0.05 or lower was considered statistically significant. Total number surveyed was 130. Average age is 64 years. Males were 76 % (99) and females 24 % (31). More than 50 % were Lebanese and 28 % were from Yemen. Majority had health insurance (89 %), and 86 % had a primary care physician of which 79 % of them spoke Arabic. Half of the participants had colonoscopy mostly for screening purposes. Fifty-eight (45 %) participants did not have CRC screening. Majority of the females (72.4 %) had colonoscopy compared to 46.8 % of the males (p value = 0.016). The mean length of stay in the U.S was 39.16 years in the colonoscopy group compared to 30.77 years in the non-screening group (p value = 0.006). Participants without a PCP did not have CRC screening (77.8 %) (p value = 0.005). Participants with a non-Arabic speaking PCP had more colonoscopy rates (77.3 %) compared to those with an Arabic speaking PCP (50 %) (p value = 0.027). More Lebanese had colonoscopy (71.9 %) compared to 25.7 % of the surveyed Yemenis (p value = 0.00). Discomfort, unawareness about CRC screening, and nonrecommendation by PCP were reported barriers. Arab-Americans have lower screening colonoscopy rates. Unfamiliarity of the importance of screening is a principal issue. Having a non-arabic speaking PCP is beneficial. Better education to this population about the benefits and ease of screening could increase adherence to screening for this population.

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References

  1. Department of Health and Human Services CfDCaP, and National Cancer Institute. (2012). United States Cancer Statistics: 1999–2008 incidence and mortality web-based report.

  2. Siegel, R., Naishadham, D., & Jemal, A. (2012). Cancer statistics, 2012. CA Cancer Journal for Clinicians, 62, 10–29. doi:10.3322/caac.20138. Epub 2012 Jan 4.

    Article  Google Scholar 

  3. Djenaba, A., Joseph, M., Jessica, B., King, M. P. H., Jacqueline, W., Miller, M. D., Lisa, C., & Richardson, M. D. (2012). Prevalence of colorectal cancer screening among adults—behavioral risk factor surveillance system, United States, 2010. CDC MMWR 2012.

  4. Group. (2010). USCSW. United States Cancer Statistics: 1999–2007 Incidence and Mortality Web-based Report.

  5. Prevention. (2011). CfDCa. Colorectal (Colon) Cancer—colorectal cancer statistics.

  6. Centers For Disease Control and Prevention (CDC). http://www.cdc.gov/cancer/colorectal/statistics/screening_rates.htm.

  7. U.S. Department of Health and Human Services CfDCaP. (2010). Behavioral risk factor surveillance system survey data. Centers for Disease Control and Prevention (CDC).

  8. Stewart, S. L., King, J. B., Thompson, T. D., et al. (2004). Cancer mortality surveillance–United States, 1990–2000. MMWR Surveillance Summaries, 53, 1–108.

    Google Scholar 

  9. http://www.aaiusa.org/.

  10. http://2010.census.gov/2010census/.

  11. MDoCH. (2010). Behavioral risk factor survey: Estimates for risk factors and health indicators. Michigan behavioral risk factor surveillance system, 2011.

  12. MDoCH. (2011). Behavioral risk factor survey: Estimates for risk factors and health indicators, 2010. Michigan behavioral risk factor surveillance system, 2010.

  13. Schwartz, K. L., Kulwicki, A., Weiss, L. K., et al. (2004). Cancer among Arab Americans in the metropolitan Detroit area. Ethnicity and Disease, 14, 141–146.

    PubMed  Google Scholar 

  14. Nasseri, K., Mills, P. K., & Allan, M. (2007). Cancer incidence in the Middle Eastern population of California, 1988–2004. Asian Pacific Journal of Cancer Prevention, 8, 405–411.

    PubMed  Google Scholar 

  15. Dimou, A., Syrigos, K. N., & Saif, M. W. (2009). Disparities in colorectal cancer in African-Americans vs Whites: Before and after diagnosis. World Journal of Gastroenterology, 15, 3734–3743.

    Article  PubMed  Google Scholar 

  16. Meissner, H. I., Breen, N., Klabunde, C. N., et al. (2006). Patterns of colorectal cancer screening uptake among men and women in the United States. Cancer Epidemiology, Biomarkers and Prevention, 15, 389–394.

    Article  PubMed  Google Scholar 

  17. Diaz, J. A., Roberts, M. B., Clarke, J. G., et al. (2012). Colorectal cancer screening: Language is a greater barrier for Latino men than Latino women. Journal of Immigrant and Minority Health. doi:10.1007/s10903-012-9667-6.

  18. Oliver, J. S., Worley, C. B., DeCoster, J., et al. (2012). Disparities in colorectal cancer screening behaviors: Implications for African American men. Gastroenterology Nursing, 35, 93–98.

    Article  PubMed  Google Scholar 

  19. Dominic, O. G., McGarrity, T., Dignan, M., et al. (2009). American College of Gastroenterology guidelines for colorectal cancer screening 2008. American Journal of Gastroenterology, 104, 2626–2627. author reply 2628–9.

    Article  PubMed  Google Scholar 

  20. Vijan, S., Hwang, E. W., Hofer, T. P., et al. (2001). Which colon cancer screening test? A comparison of costs, effectiveness, and compliance. The American Journal of Medicine, 111, 593–601.

    Article  PubMed  CAS  Google Scholar 

  21. Goel, M. S., Wee, C. C., McCarthy, E. P., et al. (2003). Racial and ethnic disparities in cancer screening. Journal of General Internal Medicine, 18, 1028–1035.

    Article  PubMed  Google Scholar 

  22. Centers for Disease Control and Prevention. (2007). Colorectal cancer test use–Maryland, 2002–2006. MMWR. Morbidity and Mortality Weekly Report, 2007(56), 932–936.

    Google Scholar 

  23. Ananthakrishnan, A. N., Schellhase, K. G., Sparapani, R. A., et al. (2007). Disparities in colon cancer screening in the Medicare population. Archives of Internal Medicine, 167, 258–264.

    Article  PubMed  Google Scholar 

  24. Wilkins, T., Gillies, R. A., Harbuck, S., et al. (2012). Racial disparities and barriers to colorectal cancer screening in rural areas. Journal of American Board of Family Medicine, 25, 308–317.

    Article  Google Scholar 

  25. Walsh, J. M., Kim, S. E., & Sawaya, G., et al. (2012). Colorectal cancer screening: What do women from diverse ethnic groups want? Journal of General Internal Medicine.

  26. Salz, T., Woo, H., Starr, T. D., et al. (2012). Ethnic disparities in colonoscopy use among colorectal cancer survivors: A systematic review. Journal of Cancer Survivorship.

  27. Shahidi, N. C., Homayoon, B., Cheung, W. Y. (2012). Factors associated with suboptimal colorectal cancer screening in US immigrants. American Journal of Clinical Oncology.

  28. Gimeno Garcia, A. Z. (2012). Factors influencing colorectal cancer screening participation. Gastroenterology Research and Practice, 2012, 483417.

    Article  PubMed  Google Scholar 

  29. Ellison, J., Jandorf, L., Villagra, C., et al. (2011). Screening adherence for colorectal cancer among immigrant Hispanic women. Journal of the National Medical Association, 103, 681–688.

    PubMed  Google Scholar 

  30. Palmer, R. C., Chhabra, D., & McKinney, S. (2011). Colorectal cancer screening adherence in African-American men and women 50 years of age and older living in Maryland. Journal of Community Health, 36, 517–524.

    Article  PubMed  Google Scholar 

  31. Sly, J. R., Edwards, T., Shelton, R. C., et al. (2012). Identifying barriers to colonoscopy screening for nonadherent African American participants in a patient navigation intervention. Health Education & Behaviour, 19, 19.

    Google Scholar 

  32. Matin, M., & LeBaron, S. (2004). Attitudes toward cervical cancer screening among Muslim women: A pilot study. Women and Health, 39, 63–77.

    Google Scholar 

  33. Naffm, A. (1993). Becoming American: The early Arab immigrant experience. Carbondale, IL: Southern Illinois University Press.

  34. Percac-Lima, S., Grant, R. W., Green, A. R., et al. (2009). A culturally tailored navigator program for colorectal cancer screening in a community health center: A randomized, controlled trial. Journal of General Internal Medicine, 24, 211–217.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Oakwood Hospital and Medical Center, 18101 Oakwood Blvd, Dearborn, MI, 48124, USA

    Nizar Talaat & Walid Harb

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  1. Nizar Talaat
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  2. Walid Harb
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Correspondence to Nizar Talaat.

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Talaat, N., Harb, W. Reluctance to Screening Colonoscopy in Arab Americans: A Community Based Observational Study. J Community Health 38, 619–625 (2013). https://doi.org/10.1007/s10900-013-9688-7

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