Janeth I. Sanchez, Rebecca Palacios, Beti Thompson, Vanessa Martinez, Mary A. O’Connell

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Plant and Environmental Sciences, New Mexico State University, Las Cruces, New Mexico, USA.
Public Health Sciences, New Mexico State University, Las Cruces, New Mexico, USA.
Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
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Abstract: Purpose: Colorectal cancer (CRC) mortality rates in New Mexico (NM) continue to be higher than national rates. Hispanic CRC mortality rates in NM surpass those of overall Hispanics in the US. This study was designed to characterize and understand factors contributing to low CRC screening rates in this border region. Methods: A CRC Knowledge Assessment Survey (KAS) was administered in either English or Spanish to 247 individuals attending community events throughout southern NM. A subset of these individuals completed an online CRC risk assessment survey managed by the National Cancer Institute (NCI). Data analysis tested for significant differences in knowledge, physician-patient CRC interactions, CRC risk level perception, and screening rates across diverse ethnic and age groups. Results: Both CRC knowledge and physician-patient CRC interactions were positively associated with participant screening history. Significant age and ethnic differences for CRC knowledge, physician-patient CRC interactions, and screening history in the NM border sample were also seen. Age-eligible Hispanics (50+) as well as those less than 50 years of age had lower CRC knowledge and were less likely to engage in physician-patient CRC interactions than non-Hispanic Whites (NHWs). The age-eligible Hispanics also reported lower CRC screening rates than their NHW counterparts. Conclusions: Low CRC knowledge and limited physician-patient CRC interactions appear to contribute to low screening rates in this NM population. Expanding education and outreach efforts for this border population are essential to promote early CRC detection and thereby decrease overall CRC mortality rates.

Keywords: Colorectal Cancer; Health Disparity; Hispanics; Knowledge; New Mexico; Screening

Cite this paper: J. Sanchez, R. Palacios, B. Thompson, V. Martinez and M. O’Connell, "Assessing Colorectal Cancer Screening Behaviors and Knowledge among At-Risk Hispanics in Southern New Mexico," Journal of Cancer Therapy, Vol. 4 No. 6, 2013, pp. 15-25. doi: 10.4236/jct.2013.46A2003.

References

[1]   American Cancer Society, “Cancer Facts and Figures 2012,” American Cancer Society, Atlanta, 2012. http://www.cancer.org

[2]   D. Naishadham, I. Lansdorp-Vogelaar, R. Siegel, V. Cokkinides and A. Jemal, “State Disparities in Colorectal Cancer Mortality Patterns in the United States,” Cancer Epidemiol Biomarkers Prevention, Vol. 20, No. 7, 2011, pp. 1296-1302. doi:10.1158/1055-9965.EPI-11-0250

[3]   L. Richardson, E. Tai, S. Rim, D. Joseph and M. Plescia, “Vital Signs: Colorectal Cancer Screening, Incidence, and Mortality-United States, 2002-2010,” Morbidity and Mortality Weekly Report, Vol. 60, No. 26, 2011, pp. 884-889.

[4]   N. Howlander, A. Noone, M. Krapcho, et al., “SEER Cancer Statistics Review, 1975-2009,” National Cancer Institute, Bethesda, 2012. http://seer.cancer.gov/csr/1975_2009_pops09

[5]   National Cancer Institute, “Surveillance Epidemiology and End Results, Cancer Statistics, Fast Stats, Race and Ethnicity, 2003-2007 Average,” Department of Health and Human Services, 2013. http://seer.cancer.gov/faststats/selections.php?

[6]   New Mexico Tumor Registry, “Cancer of the Colon and Rectum in New Mexico,” University of New Mexico, 2012. http://som.unm.edu/nmtr/common/docs/Colon and Rectum.pdf

[7]   J. A. Shapiro, C. N. Klabunde, T. D. Thompson, M. R. Nadel, L. C. Seeff and A. White, “Patterns of Colorectal Cancer Test Use, Including CT Colonography, in the 2010 National Health Interview Survey,” Cancer Epidemiology, Biomarkers & Prevention, Vol. 21, No. 6, 2012, pp. 895-904. doi:10.1158/1055-9965.EPI-12-0192

[8]   S. W. Vernon, “Participation in Colorectal Cancer Screening: A Review,” Journal of the National Cancer Institute, Vol. 89, No. 19, 1997, pp. 1406-1422. doi:10.1093/jnci/89.19.1406

[9]   M. Maciosek, L. Solberg, A. Coffield, N. Edwards and M. Goodman, “Colorectal Cancer Screening: Health Impact and Cost Effectiveness,” American Journal of Preventive Medicine, Vol. 31, No. 1, 2006, pp. 80-89. doi:10.1016/j.amepre.2006.03.009

[10]   US Preventative Services Task Force, “Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement,” Annals of Internal Medicine, Vol. 149, No. 9, 2008, pp. 627-637. doi:10.7326/0003-4819-149-9-200811040-00243

[11]   Centers for Disease Control (CDC), “Colorectal Cancer,” Department of Health and Human Services, 2012. http://www.cdc.gov/cancer/colorectal/basic_info/screening/

[12]   R. M. Hoffman, R. Rhyne, D. Helitzer, et al., “Barriers to Colorectal Cancer Screening: Physician and General Population Perspectives, New Mexico, 2006,” Preventing Chronic Disease, Vol. 8, No. 2, 2011, pp. 1-11.

[13]   S. Winawer, R. Fletcher, D. Rex, et al., (2003) “Colorectal Cancer Screening And Surveillance: Clinical Guidelines and Rationale—Update Based on New Evidence,” Gastroenterology, Vol. 124, No. 2, 2003, pp. 544-600. doi:10.1053/gast.2003.50044

[14]   C. N. Klabunde, D. Lanier, M. R. Nadel, C. McLeod, G. Yuan and S. W. Vernon, “Colorectal Cancer Screening by Primary Care Physicians: Recommendations and Practices, 2006-2007,” American Journal of Preventive Medicine, Vol. 37, No. 1, 2009, pp. 8-16. doi:10.1016/j.amepre.2009.03.008

[15]   T. Read and I. Kodner, “Colorectal Cancer: Risk Factors and Recommendations for Early Detection,” American Family Physician, Vol. 59, No. 11, 1999, pp. 3083-3092

[16]   R. Smith, V. Cokkinides, H. Eyre and A. C. Society, “American Cancer Society Guidelines for the Early Detection of Cancer, 2004,” CA: A Cancer Journal for Clinicians, Vol. 54, No. 1, 2004, pp. 41-52. doi:10.3322/canjclin.54.1.41

[17]   H. Le, A. Ziogas, S. M. Lipkin and J. A. Zell, “Effects of Socioeconomic Status and Treatment Disparities in Colorectal Cancer Survival,” Cancer Epidemiology, Biomarkers & Prevention, Vol. 17, No. 8, 2008, pp. 1950-1962. doi:10.1158/1055-9965.EPI-07-2774

[18]   Office of Disease Prevention and Health Promotion, “Healthy People 2020: Improving the Health of Americans,” Department of Health and Human Services, 2012. http://www.healthypeople.gov/ 2020/topicsobjectives2020/ objectiveslist.aspx?topicId = 5

[19]   Centers for Disease Control (CDC), “Behavioral Risk Factor Surveillance System Survey Data,” 2010. http://www.cdc.gov/cancer/colorectal/statistics/screening_rates.htm

[20]   New Mexico Department of Health, “New Mexico Cancer Facts and Figures,” 2007. http://www.cancernm.org/cancercouncil/ facts_figures.htm

[21]   M. Gonzales, H. Nelson, R. L. Rhyne, S. N. Stone and R. M. Hoffman, “Surveillance of Colorectal Cancer Screening in New Mexico Hispanics and Non-Hispanic Whites,” Journal of Community Health, Vol. 37, No. 6, 2012, pp. 1279-1288. doi:10.1007/s10900-012-9568-6

[22]   US Census Bureau, “State and County QuickFacts: New Mexico,” 2012. http://quickfacts.census.gov/ qfd/states/35000.html

[23]   US Census Bureau, “Small Area Income and Poverty Estimates: State and Country Maps”. http://www.census.gov/did/www/saipe/data/statecounty/maps/2010.html

[24]   US HUD, “US Department of Housing and Urban Development: Homes & Communities. Facts about FarmWorkers and Colonias,” 2008. http://www.hud.gov/groups/farmwkercolonia.cfm

[25]   US Census Bureau, “Health Insurance Coverage Status. 2009-2011 American Community Survey 3-Year Estimates,” 2012. http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview. xhtmlpid=ACS_11_3YR_S2701&prodType=table

[26]   New Mexico Human Services Department, “New Mexico Uninsured Population and Income Data,” 2008. http://www.hsd.state.nm.us/pdf/UninsuredPopulationData5-14-08.pdf

[27]   S. Kim, E. Perez-Stable, S. Wong, et al., “Association between Cancer Risk Perception and Screening Behavior among Diverse Women,” Archives of Internal Medicine, Vol. 168, No. 7, 2008, pp. 728-734. doi:10.1001/archinte.168.7.728

[28]   D. W. Shin, Y. W. Kim, J. H. Oh, et al., “Knowledge, Attitudes, Risk Perception, and Cancer Screening Behaviors among Cancer Survivors,” Cancer, Vol. 117, No. 16, 2011, pp. 3850-3859. doi:10.1002/cncr.25951

[29]   P. Sanderson, N. Weinstein, N. Teufel-Shone and M. Martinez, “Assessing Colorectal Cancer Screening Knowledge at Tribal Fairs,” Preventing Chronic Disease, Vol. 8, No. 1, 2011, pp. 1-10.

[30]   M. Wolf, A. Rademaker, C. Bennet, et al., “Development of a Brief Survey on Colon Cancer Screening Knowledge and Attitudes among Veterans,” Preventing Chronic Disease, Vol. 2, No. 2, 2005, pp. 1-10.

[31]   G. D. Coronado, I. Golovaty, G. Longton, L. Levy and R. Jimenez, “Effectiveness of a Clinic-Based Colorectal Cancer Screening Promotion Program for Underserved Hispanics,” Cancer, Vol. 117, No. 8, 2011, pp. 1745-1754. doi:10.1002/cncr.25730

[32]   N. C. Dolan, M. R. Ferreira, T. C. Davis, et al., “Colorectal Cancer Screening Knowledge, Attitudes, and Beliefs among Veterans: Does Literacy Make a Difference?” Journal of Clinical Oncology, Vol. 22, No. 13, 2004, pp. 2617-2622. doi:10.1200/JCO.2004.10.149

[33]   S. Akhtar, S. Sinha, S. McKenzie, P. M. Sagar, P. J. Finan and D. Burke, “Awareness of Risk Factors Amongst First Degree Relative Patients with Colorectal Cancer,” Colorectal Disease, Vol. 10, No. 9, 2008, pp. 887-890.

[34]   H. A. Beydoun and M. A. Beydoun, “Predictors of Colorectal Cancer Screening Behaviors among Average-Risk Older Adults in the United States,” Cancer Causes & Control, Vol. 19, No. 4, 2008, pp. 339-359. doi:10.1007/s10552-007-9100-y

[35]   National Cancer Institute, “Colorectal Cancer Risk Assessment Tool,” National Institutes of Health, 2009. http://www.cancer.gov/colorectalcancerrisk/

[36]   M. E. Fernandez, R. Wippold, I. Torres-Vigil, et al., “Colorectal Cancer Screening among Latinos from U.S. Cities along the Texas-Mexico Border,” Cancer Causes & Control, Vol. 19, No. 2, 2008, pp. 195-206. doi:10.1007/s10552-007-9085-6

[37]   M. Johnson-Kozlow, “Colorectal Cancer Screening of Californian Adults of Mexican Origin as a Function of Acculturation,” Journal of Immigrant and Minority Health, Vol. 12, No. 4, 2010, pp. 454-461. doi:10.1007/s10903-009-9236-9

[38]   A. N. Freedman, M. L. Slattery, R. Ballard-Barbash, et al., “Colorectal Cancer Risk Prediction Tool for White Men and Women without Known Susceptibility,” Journal of Clinical Oncology, Vol. 27, No. 5, 2009, pp. 686-693. doi:10.1200/JCO.2008.17.4797

[39]   Y. Park, A. N. Freedman, M. H. Gail, et al., “Validation of a Colorectal Cancer Risk Prediction Model among White Patients Age 50 Years and Older,” Journal of Clinical Oncology, Vol. 27, No. 5, 2009, pp. 694-698. doi:10.1200/JCO.2008.17.4813

[40]   E. J. Coups, S. L. Manne, N. J. Meropol and D. S. Weinberg, “Multiple Behavioral Risk Factors for Colorectal Cancer and Colorectal Cancer Screening Status,” Cancer Epidemiology Biomarkers and Prevention, Vol. 16, No. 3, 2007, pp. 510-516. doi:10.1158/1055-9965.EPI-06-0143

[41]   R. R. Huxley, A. Ansary-Moghaddam, P. Clifton, S. Czernichow, C. L. Parr and M. Woodward, “The Impact of Dietary and Lifestyle Risk Factors on Risk of Colorectal Cancer: A Quantitative Overview of the Epidemiological Evidence,” International Journal of Cancer, Vol. 125, No. 1, 2009, pp. 171-180. doi:10.1002/ijc.24343

[42]   C. L. Arnold, A. Rademaker, S. C. Bailey, et al., “Literacy Barriers to Colorectal Cancer Screening in Community Clinics,” Journal of Health Communication: International Perspectives, Vol. 17, Suppl. 3, 2012, pp. 252-264. doi:10.1080/10810730.2012.713441

[43]   R. Palacios, M. Kittleson and J. Rodriguez-Herrera, “Obesity in the 51st State,” Health Education Monographs, Vol. 29, No. 1, 2012, pp. 22-30.

[44]   W. Hlaing, S. D. Nath and F. G. Huffman, “Assessing Overweight and Cardiovascular Risks among College Students,” American Journal of Health Education, Vol. 38, No. 2, 2007, pp. 83-90. doi:10.1080/19325037.2007.10598948

[45]   American Cancer Society, “Colorectal Cancer Early Detection,” 2012. http://www.cancer.org/ acs/groups/cid/documents/ webcontent/003170-pdf.pdf

[46]   V. S. Katz, A. Ang and R. Suro, “An Ecological Perspective on US Latinos’ Health Communication Behaviors, Access, and Outcomes,” Hispanic Journal of Behavioral Sciences, Vol. 34, No. 3, 2012, pp. 437-456. doi:10.1177/0739986312445566

[47]   C. Horowitz, B. Brenner, S. Lachapelle, D. Amara and G. Arniella “Effective Recruitment of Minority Populations through Community-Led Strategies,” American Journal of Preventive Medicine, Vol. 37, Suppl. 1, 2009, pp. S195-S200. doi:10.1016/j.amepre.2009.08.006

[48]   K. McCaffery, J. Wardle, M. Nadel and W. Atkin, “Socioeconomic Variation in Participation in Colorectal Cancer Screening,” Journal of Medical Screening, Vol. 9 , No. 3, 2002, pp. 104-108. doi:10.1136/jms.9.3.104