Masculinity, Racism, Social Support, and Colorectal Cancer Screening Uptake Among African American Men: A Systematic Review

Abstract

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.

Predictors of Intention to Obtain Colorectal Cancer Screening Among African American Men in a State Fair Setting

“…The authors also hypothesized these men lacked adequate knowledge and espoused negative attitudes toward CRCS. Research supports the current hypotheses, linking masculinity (male role norms) to African American men’s health behavior, mortality, and healthcare use (Courtenay, 2000; Rogers, Goodson, & Foster, 2015; Wade, 2009). Furthermore, hypotheses for this study were formulated on the basis of recommendations that to improve CRCS rates among African Americans, studies should address elements of cultural identity, CRCS beliefs, and subjective norms (Brittain et al, 2012; Rogers et al, 2015).…”

Interventions for increasing colorectal cancer screening uptake among African-American men: A systematic review and meta-analysis

“…Furthermore, as highlighted in a previous systematic review by Rogers and colleagues, there is a need to better understand the influence of sociocultural determinants that may influence African-American men’s negative responses, reluctance, and apprehension associated with CRC screening [ 103 ]. Culturally sensitive community-based interventions among African-American men should be further developed and implemented.…”

“…Cost-effectiveness strategies require an overall assessment of patient and provider barriers, the navigation system, and other potential inhibitors of CRC screening [ 105 ]. Because a significant burden of CRC and observed disparities in CRC screening uptake still exists among African-American men, programs tailored to this population should consider how to effectively enhance knowledge of the benefits of CRC screening, improve access to health care, and elevate the related insurance services [ 15 , 103 – 105 ]. In clinical settings, strategies to better utilize patient navigation systems to emphasize the importance of screening and enhance educational outreach for healthcare providers who provide routine care for African-American men could conceivably aid in lowering the cost of promoting CRC screening, particularly among low-income patients [ 105 ].…”

Identification of risk factors for neoplastic colonic polyps in young adults with bloody stool in comparison with those without symptom

“…Current guidelines from the American Gastrointestinal Association also recommended colonoscopy every 10 years or FIT annually for CRC screening and monitoring in the average‐risk group aged 50 years and older . However, shortening the colonoscopic screening interval and beginning from an earlier age were recommended in high‐risk groups such as African‐Americans, individuals with a positive family history of CRC (FHCRC), family adenomatous polyposis, and hereditary non‐polyposis CRC . Two studies proposed that metabolic syndromes should be considered in risk stratification for monitoring intervals …”