Abstract C48: Colorectal cancer among African-Americans: Examining the relationship between dietary habits, physical activity, and colorectal cancer screening to reduce cancer risk and health disparities
Authors: Kanfash Noora S. , Garza Mary A. , Assini-Meytin Luciana 
Published: February 2019

Colorectal cancer (CRC) is the second leading cancer killer in the United States affecting both men and women. It is found that African-American men and women have the highest rates of CRC as well as suffer the highest rates of mortality from CRC than any other racial or ethnic group. Research shows that unhealthy dietary habits such as a diet low in fruits and vegetables, a low-fiber and high-fat diet all contribute to an increased risk of CRC. Low levels of physical activity and being overweight or obese also contribute to an increased risk of developing CRC, and the African-American community has the highest rates of obesity (48.1%) compared to other racial and ethnic groups. CRC can be prevented through lifestyle behaviors, such as diet, physical activity, smoking, weight, and appropriate CRC screening. A majority of the literature does not specifically focus on examining how these lifestyle behaviors influence CRC screening within the African-American community. In the past few years, diabetes has emerged as a potential link with CRC. Obesity is a risk factor for comorbidities such as diabetes and hypertension and CRC. The aim of this study is to examine the relationship between dietary habits, physical activity, comorbidities, and CRC screening in the African-American community.

Methods: This study is a secondary data analysis of a longitudinal study, assessing a family health history intervention on the prevention of cancer and chronic diseases. A total of 164 participants were recruited from barbershops/salons, located in low-income urban neighborhoods in the Washington, D.C. metropolitan area. Baseline survey measures include participants' demographics, CRC screening status, family history of cancer, body mass index (BMI), diagnosed chronic diseases, dietary habits, levels of physical activity, and stress, among others. Diet was assessed at baseline with use of PrimeScreen inventory, a short dietary assessment questionnaire, the results of which compare well with extended food frequency questionnaires and biomarkers. PrimeScreen assessed self-reported intake of various foods, specifically fruits, vegetables, whole grains, fish, and red meat as well as other foods with saturated and trans fats. The survey also included the number of meals prepared away from the home and meals from fast-food establishments. Body mass index was calculated with participant self-reported height and weight. According to the Centers for Disease Control, an overweight BMI is 25-29.99 and obese BMI is ≥30. Physical activity was measured through self-reported activity level, opportunities to engage in activity, and the number of days the participant was physically active in the past 7 days.

Results: Preliminary analysis shows participants were primarily African-American (89%), female (54%), and aged ≥50 (53%). According to BMI, 52% were obese and 30% were overweight. Only 18% of participants were familiar with “MyPlate.” Participants unaware of “MyPlate” reported greater unhealthy dietary habits (p=.007). In regards to comorbidities, participants were diagnosed with high blood pressure (44.5%) and diabetes (15.2%). Only 29.9% of participants had an up-to-date CRC screening at baseline. Multivariate analysis will be presented to identify predictors of CRC screening, comorbidities, BMI, physical activity, and dietary habits.

Conclusion: A better understanding of the role that diet, physical activity, and comorbidities play among African-Americans is integral to promote healthy dietary habits to reduce obesity and cancer risk. This information can be used to inform public health interventions that specifically target dietary habits and physical activity to reduce cancer risk and ultimately reduce cancer health disparities.

Citation Format: Noora S. Kanfash, Mary A. Garza, Luciana Assini-Meytin. Colorectal cancer among African-Americans: Examining the relationship between dietary habits, physical activity, and colorectal cancer screening to reduce cancer risk and health disparities [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C48.