Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United

No abstract

Individuals with a sibling who has had colorectal cancer diagnosed before age 61 are at increased risk for colorectal cancer and may derive particular benefit from screening. Tailored interventions may increase participation in appropriate colorectal cancer screening. This study evaluated the efficacy of two tailored interventions and a generic print intervention. Participant siblings (N = 412) who were not up-to-date with colorectal cancer screening were randomly assigned to receive either a generic print pamphlet, a tailored print pamphlet, or a tailored print pamphlet and tailored counseling call. Colorectal cancer screening six months after the baseline interview was the outcome measure. Results indicated that colorectal cancer screening adherence increased among intermediate risk siblings enrolled in all three intervention groups. Participants in both tailored intervention groups reported having colorectal cancer screening at significantly higher rates than participants in the generic print group. The increase in colorectal cancer screening in the tailored print and counseling call group was not significantly higher than that achieved by the tailored print alone. Decisional balance partially mediated treatment effects. Tailored behavioral interventions are an effective NIH Public Access Author ManuscriptAnn Behav Med. Author manuscript; available in PMC 2010 April 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript method for increasing screening adherence but telephone counseling did not add significantly to treatment effects. KeywordsColorectal cancer screening; tailored interventions; intermediate risk siblingsColorectal cancer (CRC) is the fourth most commonly diagnosed cancer and the second leading cause of cancer deaths in the United States (1). Lifetime risk for CRC is approximately 5% after age 50. Individuals with a first-degree relative (FDR; sibling, parent, child) diagnosed with CRC have an estimated lifetime CRC risk of 10% (2-4). The risk increases as the age of the proband at diagnosis decreases (5,6) with estimates ranging between two and four times the average risk (3,5).Screening results in earlier detection of CRC and reduces disease-specific mortality (7,8).Various agencies have published screening guidelines for relatives of CRC patients. A number of professional organizations recommend that FDRs should follow population screening guidelines but begin CRC screening (CRCS) at a younger age than general guidelines with recommended screening starting at age 40 (9). Others specifically recommend colonoscopy starting at an age that depends on the family history (1). Estimates of CRCS among family members at increased risk for CRC have varied widely with reported rates of 22% (10), 39% (11), 55% (12), 64% (13) and 79% (14), depending upon the screening procedure examined and the targeted at-risk population.Given the increased risk for CRC among FDRs of individuals diagnosed with CRC and the relatively low participation in this at-risk population, effective me...

Latinos have a higher rate of mortality and lower rate of colorectal cancer (CRC) screening than most racial groups in the United States. This study examines the predictors of screening colonoscopy (SC) for CRC among Latinos in a patient navigation (PN) intervention. Participants were randomized to either a culturally-targeted PN group (n = 225) or a standard PN group (n = 167). Each completed an interview assessing sociodemographic and intrapersonal information. There was no difference in SC completion between PN groups (80.9 and 79.0 %). Logistic regression revealed that low language acculturation (OR = 2.22) and annual income above $10,000 (OR = 1.97) were independent predictors of completion. Both standard and culturally-targeted PN successfully increased SC completion by nearly 30 % above the recent estimation for physician-referred patients. Our findings suggest a need to further reduce barriers to SC in low income and highly acculturated Latino groups.

Recent research underscores the need for increasing use of genetic testing for cancer risk in Latinos. This study examined the influence of acculturation on attitudes, beliefs about and familiarity with genetic testing for cancer risk in a community-based sample of Latinas in East Harlem, New York City (N=103). Multivariate linear regression models analyzed the relationship of acculturation to: (1) familiarity (2) perceived benefits (3) perceived barriers and (4) concerns about abuses of genetic testing for cancer risk. Controlling for sociodemographic factors, results revealed that with increasing acculturation Latinas were more familiar with genetic testing (β=1.62, SE=0.72, p=0.03), more likely to cite perceived benefits (β=1.67, SE=0.79, p=0.04), and less likely to report perceived barriers related to genetic testing (β=−2.76, SE=1.64, p= 0.10). Study results may help inform the development of culturally-appropriate health education outreach materials and programs targeted to increase awareness, knowledge and understanding about genetic testing for cancer risk within Latinas.