Abstract B025: “Kulu the Colon”: An assessment of a colorectal cancer education intervention in Guam
Authors: Diaz Tressa P. , Sayama Maurissa , Somera Lilnabeth , Mummert Angelina 
Published: September 2020

Background. The island of Guam is a U.S. territory where a large proportion of Pacific Islanders and Filipinos reside. CHamoru, the indigenous people of Guam, have the overall highest incidence and mortality rates in colorectal cancer (CRC). CRC is the third leading cause of cancer death for both men and women on island. CRC screening data indicate 44.2% of persons age 50 and above have met USPSTF screening standards for CRC compared to 67.3% of the same cohort in the U.S. (CDC, 2019). In addition, CRC diagnoses often occur in the late stages with recent data revealing that 75.0% of these occur at Stage 3, while 18.0% occur at Stage 1 (Pacific Regional Central Cancer Registry, 2018). These late stage diagnoses have implications for early detection and CRC screening education interventions. The aim of this study was to provide CRC education via a giant inflatable colon and to assess changes in CRC knowledge, intent to screen for CRC, and willingness to discuss CRC with others. Methods. A pre- and post-test study design was used to assess changes in knowledge, beliefs, likelihood of discussing CRC screening with family members, and intent to screen after a guided tour through a giant inflatable colon. Participant response to whether the inflatable colon was a culturally appropriate education tool was also evaluated. We recruited participants at a health fair in a mall and an island-wide university event, through flyers, and convenience sampling. At the launch of the inflatable colon, we held a name-the-colon contest to engage community. The winning entry was “Kulu,” which is the CHamoru word for a conch shell and symbolizes a “call to action” to get screened for CRC. Results. A total of 201 participants completed a pre/post assessment. Majority of participants were CHamoru (40.8%) and Filipino (33.8%), female (65.0%), had a college degree (31.8%), and had health insurance (89.6%). Mean age was 36.6. Preliminary results at baseline indicate half of participants reported knowing what CRC (53.0%) and a polyp (50.5%) are. Overall, 72.4% reported knowing what a colonoscopy is and 42.4% indicated they knew what a stool test was. Prior to participating in the guided tour, 73.5% rated their general knowledge about CRC as neutral or unknowledgeable. At baseline, participants reported intent to discuss CRC screening with others (parents = 84.0%; spouses/partners = 90.3%). Conclusion. We hypothesize that using an inflatable colon to deliver CRC information: 1) increases CRC and related screening knowledge; 2) is a culturally appropriate way to provide CRC education; and 3) facilitates increased willingness to talk to others about CRC, especially among families. Pre-/post-test comparisons regarding CRC knowledge, willingness to talk to others about CRC, and intention to screen among persons 50 and above will be presented. Findings may provide insight toward more interactive CRC education for Pacific Islanders, and potentially improve CRC screening participation in Guam.

Citation Format: Tressa P. Diaz, Maurissa Sayama, Lilnabeth Somera, Angelina Mummert. “Kulu the Colon”: An assessment of a colorectal cancer education intervention in Guam [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B025.