Pathways to Colonoscopy in the South: Seeds of Health Disparities

Jain

2016

Gastroenterol. Rep.

Background: Colorectal cancer (CRC) is a common form of malignancy and a leading cause of death in the United States. Screening decreases CRC incidence and mortality. African Americans are at an increased risk of developing CRC, and recommendations are to initiate screening at the age of 45. This study aims to assess the rate of screening for colorectal cancer in African Americans between the ages of 45–49.Methods: African Americans between the ages of 45–49 were identified in the Explorys national database. Patients who completed a colonoscopy, sigmoidoscopy or fecal occult blood test were identified and stratified by sex and insurance status. A P value < 0.05 was considered significant.Results: A total of 181 200 African Americans were identified as eligible for screening. Only 31 480 patients (17.4%) received at least one screening procedure for CRC. The majority of patients (66.7%) were screened via colonoscopy. African American females were more likely to complete a screening test (17.8% vs 16.7%; P < 0.01). The majority of patients (66.0%) who completed a screening test had private insurance.Conclusion: Race, gender and barriers to medical care contribute to disparities in CRC screening rates. Among African Americans, CRC screening remains suboptimal. Tailored public health initiatives, medical record alerts and improved communication between providers and patients are fundamental to addressing issues that impact poor adherence to CRC screening in African Americans.

Section: Discussionmentioning

confidence: 99%

Colorectal cancer screening in African Americans: practice patterns in the United States. Are we doing enough?

Jain

2016

Gastroenterol. Rep.

Clinics in Colon and Rectal Surgery

“…Common barriers include limited access to providers, cost, lack of appropriate referral, and fear or lack of understanding of the procedure. [56][57][58] Given these barriers, more noninvasive tests have been developed as possible screening alternatives for CR polyps and cancer.…”

Section: Noninvasive Screening Methodsmentioning

confidence: 99%

Colonic Polyps: Diagnosis and Surveillance

Huck

Bohl

2016

Colorectal cancer begins as a polyp that is a benign growth on the mucosal surface of the colon or rectum. Over a period of 5 to 15 years, polyps can degenerate into a cancer, thus invading the colonic wall. Colorectal screening methods are designed to diagnose and remove polyps before they acquire invasive potential and develop into cancer. Screening for colorectal cancer can prevent and reduce mortality. Given the benefits and effectiveness of screening, guidelines exist from multiple organizations. These guidelines risk-stratify patients to determine the age of screening initiation and the interval for repeat screening. Categories of colorectal cancer risk include average risk, increased risk, and high risk based on individual and family medical history. Screening methods vary widely in the ability to diagnose and treat polyps and in the degree of invasiveness or risk of complication to the patient. Colonoscopy is held as the “gold standard” by which all other methods are compared; however, less-invasive modalities including computed tomographic colonography are increasing in popularity.

Journal of Language and Social Psychology

“…Perceived risk of a health threat and perceived efficacy of completing a risk-reduction behavior are two theoretical constructs shown to influence the effects of message framing on decisional outcomes, such as screening behavior (Carcioppolo et al, 2013). As a FIT reduces many of the structural barriers still associated with traditional CRC screening methods, focus has shifted to understanding the relationship that the perceived risk (susceptibility) of cancer and perceived benefit (response efficacy) of this relatively new screening modality have on patient uptake (Curbow et al, 2015; King-Marshall et al, 2016). Therefore, we propose the following hypothesis and research question:…”

Section: Using Verbal Immediacy To Frame Cancer Screening Guidelinesmentioning

confidence: 99%

Innovation or Inconsistency? Framing Colorectal Cancer Guidelines to Improve Public Perceptions of Updated Screening Recommendations

Neil

Krieger

Kalyanaraman

et al. 2016

Self Cite

Effectively communicating how findings from population science inform patient-level decision-making about cancer prevention remains a challenge. Despite the substantial benefits associated with early detection of colorectal cancer, patient compliance with screening guidelines is suboptimal. One potential barrier to compliance is the language used by organizations to frame screening recommendations. Drawing on theory and research on verbal immediacy, the current study examines whether linguistically framing screening messages as being temporally immediate makes them more effective than non-immediate messages for encouraging people to adopt state-of-science screening recommendations. An online message design experiment was conducted with a sample of older adults ( N = 305). Results show temporally immediate frames are more effective at increasing behavioral intention to follow updated screening guidelines than temporally non-immediate frames. In addition, both response efficacy of a screening modality and perceived susceptibility to cancer moderate the relationship between message strategy and intention to screen.