Racial and Socioeconomic Disparities in Cancer-Related Knowledge, Beliefs, and Behaviors in Indiana

Abstract

Background: This statewide survey examined differences in cancer-related knowledge, beliefs, and behaviors between racial and socioeconomic groups in select counties in Indiana.Methods: A stratified random sample of 7,979 people aged 18-75 who lived in one of 34 Indiana counties with higher cancer mortality rates than the state average, and were seen at least once in the past year in a statewide health system were mailed surveys.Results: Completed surveys were returned by 970 participants, yielding a 12% response rate. Black respondents were less likely to perceive they were at risk for cancer and less worried about getting cancer. Individuals most likely to perceive that they were unlikely to get cancer were more often black, with low incomes (less than $20,000) or high incomes ($50,000 or more), or less than a high school degree. Black women were greater than six times more likely to be adherent to cervical cancer screening. Higher income was associated with receiving a sigmoidoscopy in the last 5 years and a lung scan in the past year. Those with the highest incomes were more likely to engage in physical activity. Both income and education were inversely related to smoking.Conclusions: Socioeconomic and racial disparities were observed in health behaviors and receipt of cancer screening. Black individuals had less worry about cancer.Impact: Understanding populations for whom cancer disparities exist and geographic areas where the cancer burden is disproportionately high is essential to decision-making about research priorities and the use of public health resources.

Colonoscopy and Sigmoidoscopy Use among the Average-Risk Population for Colorectal Cancer: A Systematic Review and Trend Analysis

“…Among them, 72 qualified for full-text screening and 23 were considered eligible for the review. Fourteen reports provided estimates for the US (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38). The other studies were conducted in Australia (one study; ref.…”

“…For the US (Table 1), lifetime utilization of colonoscopy was reported in two studies, both on specific racial groups [Chinese or Chinese Americans living in San Francisco: 31% (27); African Americans from two metropolitan areas: 78% (30)]. Recent use of colonoscopy, mostly defined as colonoscopy use within 10 years, was reported in seven studies (25,26,28,29,31,36,38) (25). Overall, the extracted data point toward an ongoing increase in colonoscopy use over the last two decades [observed in Smith and colleagues (36) and Levin and colleagues (29)].…”

“…As far as sigmoidoscopy utilization is concerned, six studies were included [four on sigmoidoscopy use within five years (26,29,31,38), one on lifetime sigmoidoscopy use (27) and one on sigmoidoscopy use assessed over a four-year period (28)]. Overall, the estimates for sigmoidoscopy use were substantially lower when compared with colonoscopy use (0.4%-27%) and seem to have strongly decreased over time.…”

“…Sex-and age-specific estimates obtained from the NHIS data are further addressed in this review under Trend analysis of colonoscopy utilization in Germany and the US. In addition, three studies reported race-specific estimates (31,33,38). Two studies (including one nationally representative study; ref.…”

“…Two studies (including one nationally representative study; ref. 33) described Whites as the group with the highest uptake (33,38). The other study, conducted in the context of an organized screening program in Southern California, identified a higher proportion of Asians than non-Hispanic Whites being up-to-date with screening colonoscopy (31).…”