Colorectal cancer (CRC) is highly preventable when CRC screening is utilized, yet CRC screening completion among African American men is relatively low and their mortality rates remain 50% higher juxtaposed to their White counterparts. Since a growing body of literature indicates masculinity, racism, and social support each have strong influences on CRC screening uptake, this systematic review examined the connections between these three sociocultural factors and CRC screening uptake among African American men. Potential studies were retrieved from MEDLINE, CINAHL, EMBASE, and PsycINFO. Cited reference searching for the final sample was employed to identify and assess additional studies for inclusion using Scopus. The methodological quality of the reviewed evidence was also evaluated. Nineteen studies met inclusion/exclusion criteria. Thirteen studies employed nonexperimental research designs; a quasi-experimental design was present in four, and two utilized experimental designs. Studies were published between 2000 and 2014; the majority between 2009 and 2013. Social support was most frequently addressed (84%) while masculinity and racism were equally studied with paucity (11%) for their influence on CRC screening. After evaluating conceptual and methodological characteristics of the studies, 42% fell below average in quality and rigor. The need for increased attention to the sociocultural correlates of CRC screening for African American men are highlighted in this systematic review, and important recommendations for research and practice are provided. Alongside a call for more rigorous research, further research examining the influence of masculinity and racism on CRC screening completion among African American men is warranted.
BACKGROUND: Colorectal cancer (CRC) is both preventable and highly treatable, yet incidence and mortality rates are 25% and 50% higher among African American men compared to their white counterparts. This disproportionate burden places African American men last among all racial/ethnic groups of both genders for age-adjusted CRC mortality rates and five-year survival rates. These disparities are well documented, yet preventive screening completion among African American men is relatively low, understudied, and poorly explicated. A growing body of literature indicates that separately, masculinity, racism, and social support are strong influences on CRC screening uptake.
METHODS: We conducted a systematic review with the purpose of identifying and synthesizing the connections between extant literature on the associations between masculinity, racism, social support, and CRC screening completion. Utilizing Garrard's Matrix Method, 19 studies met inclusion/exclusion criteria; and the methodological quality of the reviewed evidence was assessed.
CONCLUSIONS: Thirteen studies employed non-experimental research designs; a quasi-experimental design was present in four, and two utilized experimental designs. Studies were published between 2000 and 2014; the majority within five years. Preliminary qualitative synthesis suggests that social support was most frequently addressed (79%), while masculinity and racism were equally examined (11%) for their influence on CRC screening. After evaluating the conceptual and methodological characteristics of included studies, 42% fell below average in quality and rigor. The need for increased attention to the sociocultural correlates of CRC screening for African American men are highlighted in this systematic review, and important recommendations for research and practice are provided.
Citation Format: Charles R. Rogers, Jamie A. Mitchell, Gabriel J. Franta, Margaret J. Foster, Deirde Shires. The influence of masculinity, racism, and social support on colorectal cancer screening uptake among African American men: A systematic review. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3742. doi:10.1158/1538-7445.AM2015-3742
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