Abstract A051: Race and gender differences in awareness of colorectal cancer screening tests among recently diagnosed colon cancer
Authors: Carnahan Leslie R. , Jones Lindsey , Brewer Katherine , Molina Yamile , Rauscher Garth 
Published: August 2020

Background: Non-Hispanic Black (NHB) populations, compared to non-Hispanic Whites (NHW), are less likely to receive guideline concordant colorectal cancer (CRC) screening. CRC screening barriers are multifaceted and involve factors including health care access and utilization, sociodemographic characteristics, and individuals' beliefs and awareness about cancer, screening tests, and guidelines. Inability to recall or recognize CRC tests and low knowledge of screening guidelines may contribute to disparate outcomes across the colon cancer continuum.

Objective: In the present study, we sought to 1) characterize the prevalence of urban colon cancer patients' awareness of screening tests and guidelines, and 2) examine if awareness and knowledge of guidelines were associated with mode of cancer detection (screen-detected versus symptomatic presentation).

Methods: The Colon Cancer Patterns of Care in Chicago study was a descriptive cross-sectional study that examined racial, gender, and SES disparities in CRC screening, care initiation, diagnostic stage, and subsequent treatment. Eligible patients were NHB and NHW, aged 45-79, with first primary invasive colon cancer, and were recruited from nine diverse, urban health care institutions. After consent, participants completed an in-person interview wherein they responded to questions related to the recall and recognition of colon cancer stool, sigmoidoscopy, and colonoscopy screening tests and knowledge of screening guidelines, diagnostic pathways and treatment, sociodemographic characteristics, and health care access and utilization. They received $100 for completing the interview and consenting to medical record abstraction. Logistic regression was used to model the association between knowledge and awareness variables and colon cancer mode of detection (symptomatic versus screen detection). incorporating nonresponse weights created to account for differences in response rate by facility, age, race and gender, and models were, and controlling for age, race, gender and the composite SES variable in all models.

Results: Recall of stool testing and sigmoidoscopy was low (13% and 5%); name recognition of these tests was 59% and 30%, respectively. Correct guideline knowledge was low for all three tests (7% for sigmoidoscopy, 14% for FOBT, and 19% for colonoscopy). Recall, recognition, and knowledge were lower for NHB and socioeconomically disadvantaged patients. Inability to name or recall a single test was associated with reduced screen-detection compared with recall of at least one test (36% vs. 22%, p=0.01).

Discussion: Our results should help to identify target populations in need of enhanced education and additional prompting by their health care providers to ensure that they obtain the necessary surveillance for colon cancer over the long term.

Citation Format: Leslie R. Carnahan, Lindsey Jones, Katherine Brewer, Yamile Molina, Garth Rauscher. Race and gender differences in awareness of colorectal cancer screening tests among recently diagnosed colon cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A051.