Colorectal cancer knowledge and screening adherence among low-income Hispanic employees

Abstract

Hispanics have the lowest colorectal cancer (CRC) screening rates of all racial/ethnic groups and comprise the largest proportion of low-income manual laborers in the nation. We partnered with businesses to implement a community health worker (CHW)-led intervention among Hispanic workers in service-related and manual labor occupations, which often pay low wages and do not provide health insurance. CHWs measured knowledge, screening adherence and perceptions of CRC risk before and after educational interventions via interview. CHWs provided fecal immunochemical tests (FITs) to participants aged ≥50 years. Chi-square tests and logistic regression identified pre-intervention predictors of CRC knowledge of all participants and adherence among eligible participants. Adherence among participants increased from 40% (n = 307) pre-intervention to 66% post-intervention. Knowledge about CRC was associated with age ≥50 years (OR = 8.90 [95% CI = 2.61–30.35]; ref = 18–30) and perceived personal risk for CRC (Likely, OR = 3.06 [95% CI = 1.40–6.67]; ref = Not likely). Insurance status was associated with screening adherence pre-intervention (OR = 3.00 [95% CI 1.10–8.12]; ref = No insurance). Improvement in adherence post-intervention was associated with income between $25 000 and ≥$55 000 (OR = 8.49 [95% CI 1.49–48.32]; ref = $5000–<$10 000). Community-based health programs can improve CRC screening adherence among Hispanic workers in service-related and manual labor positions, but lowest-income workers may need additional support.

Genetic Testing for Cancer Risk and Perceived Importance of Genetic Information Among US Population by Race and Ethnicity: a Cross-sectional Study

“…Cancer risk perception by hereditary risk may not be a decisive factor that drives genetic testing and other preventive care uptakes. Prior studies on cancer risk perception and screening adherence also found no significant association among racial and ethnic minorities [ 33 , 34 ]. It is also possible that racial and ethnic minority groups may face greater difficulty accessing cancer genetic testing despite higher cancer risk perception (e.g., testing cost burden, distrust in health provider) [ 35 – 37 ].…”

Colorectal surveillance outcomes from an institutional longitudinal cohort of lynch syndrome carriers

“…Although LS carriers carry significant lifetime risk for the development of CRC regardless of ethnicity and race, patients belonging to racial and ethnic minorities in the United States are less likely to receive genetic evaluation for inherited CRC syndromes and may not receive sufficient screening following diagnosis ( 15 ). This discrepancy has been correlated to a lack of patient education on adequate screening modalities leading to stigmatization of screening practice, the potential effects of oncologists’ implicit biases in patient-physician interactions, and the insurance disparities between Hispanic and non-Hispanic populations ( 16 – 18 ). In contrast to the literature, we showed no significant difference in interval screening between Hispanics and non-Hispanics in our cohort.…”

Knowledge and awareness of colorectal cancer among a predominantly Indigenous Caribbean community

“…There were some missing responses, and these are noted in the tables. Questions pertaining to colorectal cancer screening were derived from the 2015 US Behavioral Risk Factor Surveillance System (BRFSS) survey [ 15 ] and have previously been applied in community surveys conducted by our team among immigrant and non-English speaking participants in the United States [ 16 , 17 ].…”