Abstract A43: Comparison of colorectal cancer perceptions among two different predominantly Hispanic community populations
Authors: Fernandez Norma P. , Shokar Navkiran , Guillen-Gomez Laura , Morera Osvaldo F. 
Published: June 2012

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States (Healthy People 2010 Report). According to the Texas Cancer Registry, CRC is the third most prevalent cancer in the El Paso area. Research has shown that 50–60% of CRC cases can be prevented if screening is done as recommended. Although adequate quantities of CRC health literature are available, the majority of Hispanic health consumers needing CRC screenings lack adequate education of the various CRC procedures and their benefits (Beeker, et al., 2000; Kim & Morera, 2002; Pollack et al., 2006). A report conducted by Kim and Morera (2002) found that Hispanics had different beliefs about CRC screening than their non-Hispanic counterparts. Active patient involvement in their medical decision making has been shown to lead to improved medical outcomes (Greenfield et al., 1995). The present study reports qualitative data on colorectal cancer and screening decision aids for Hispanic Americans living in border towns adjacent to Mexico to try to understand the existence of any barriers.

Methods: A qualitative study consisting of 19 focus groups was conducted. A total of 11 groups were conducted in English, 5 in Spanish and 3 in both languages. The criteria for eligibility consisted of being 50 years or older and El Paso county resident. Focus groups were held at the University of Texas at El Paso, community based clinics, and senior centers throughout the County. Sessions lasted 1 hour. Participants were asked to sign a consent form and completed a demographic questionnaire. After each focus group session, participants were debriefed. Each focus group session was lead by a trained moderator, using as a guide a set of questions previously established by the team of researchers. All focus group sessions were recorded with the consent of all participants and kept confidential. All recordings were transcribed by two different assistants and evaluated to find major themes and sub-themes. A coding framework was developed based on the participants’ comments. Broad topics and salient points were identified to evaluate overlapping themes.

Results: A total of 102 individuals participated in the focus groups. The majority of the participants (53.9%) were women. In the English-speaking groups more than a third of the participants had some college training (40%), where as in the Spanish-speaking and bilingual groups 51.9% had a 9th grade education or less. There were six major themes covered across focus group sessions: current knowledge, barriers, external controls, desired information, decision aid tools, and elements of persuasion. We found that not only participants lacked education about CRC and screenings but across focus groups, participants had some misleading information such as Hispanics are not at risk for CRC, men are more prone to CRC, CRC is not hereditary, and CRC cannot be diagnosed on its early stages. Furthermore, participants shared, based on their past experience, various means to communicate and educate the community in an effective manner.

In spite of the large body of information on CRC and screening, there were many misconceptions and lack of meaningful knowledge across focus groups. However, faith, fate, and family play a large role as decision aid tools in getting screened. Furthermore, networks of family and friends seem effective dissemination tools to advocate CRC screening. These networks would be efficient in dissipating misinformation and reducing fear of procedures with the accurate information. Furthermore, according to their suggestions, several decision aid tools should be incorporated and presented together as one large and more comprehensive decision aid tool to help individuals make informed decisions.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A43.