Abstract B76: Optimism and barriers to colonoscopy in low-income Latinos at average risk for colorectal cancer
Authors: Efuni Elizaveta , Jandorf Lina , Villagra Cristina , Winkel Gary , Starr Tatiana , DuHamel Katherine N. 
Published: May 2015

Purpose: Colorectal cancer (CRC) can be prevented and treated effectively when detected early, especially via colonoscopy. However, only 39% of CRC cases in the United States are detected early. CRC screening continues to be underutilized particularly by Latinos, the largest minority group in the U.S. As colonoscopy is considered by many to be the gold standard for screening, it is important to reduce barriers to colonoscopy screening, particularly among Latinos, and then develop targeted interventions to increase colonoscopy screening. One identified barrier to colonoscopy screening is CRC related distress as measured by fear and worry about colonoscopy. The purpose of this study is to explore how optimistic and fatalistic beliefs relate to fear and worry about CRC and screening colonoscopy. If these relationships are better understood, we can attempt to alleviate CRC-related distress by developing, or revising, culturally targeted health education interventions to reduce fatalistic beliefs and promote optimism about colonoscopy screening in Latino population. Such intervention, in turn, could lead to increased colonoscopy screening in this underserved population.

Procedures: Baseline data from the first 100 participants of an IRB approved intervention study to increase colonoscopy screening among Latinos was collected via in-person interview. Eligibility criteria included: 1) self-identified Latino; 2) ages 50-85; 3) no personal or family history of CRC below age 60; 4) no history of gastrointestinal disorder; 5) no colonoscopy procedure in the last 5 years; 6) referral for screening colonoscopy by Primary Care Provider; and 7) English or Spanish speaker. Sociodemographic, medical, and psychosocial data were collected. Psychosocial measures included: 1) optimism (Life Orientation Test – Revised (LOT-R)); 2) worry (a 3 item measure developed by Vernon et al.); 3) fatalism (a 5 item abbreviated version of Powe's fatalism measure); 4) and fear (a 6-item measure used in our prior research).

Results: Greater optimism, lower fatalism, and an absence of family history of cancer were associated with decreased CRC worry (p&lt;0.05). Greater optimism, presence of a regular PCP, and absence of family history of cancer were associated with decreased CRC fear (p&lt;0.05). Although fatalism and optimism were negatively correlated (-.869; p&lt;001), there was no significant relationship between fear and fatalism while a significant negative relationship was present for fear and optimism.

Conclusions: Optimism appears to have a negative relationship with both components of distress: fear and worry; while fatalism is only positively correlated with worry but not fear. In addition, individuals with family history of any cancer type experience greater CRC distress. Interventions that promote optimistic beliefs may be able to reduce both level of fear and worry among Latinos referred for colonoscopy and potentially have a positive effect on screening outcomes.

Citation Format: Elizaveta Efuni, Lina Jandorf, Cristina Villagra, Gary Winkel, Tatiana Starr, Katherine N. DuHamel. Optimism and barriers to colonoscopy in low-income Latinos at average risk for colorectal cancer. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr B76. doi:10.1158/1538-7755.DISP13-B76