Interventions Promoting Colorectal Cancer Screening in the Hispanic Population: A Review of the Literature

AbstractPurpose: To review the literature on the interventions used in the promotion of colorectal cancer (CRC) screening in the Hispanic population.Organizing Construct: CRC screening and Hispanic AmericansMethods: Literature published between 1999 and 2010 was reviewed using PubMed, Cumulative Index to Nursing and Allied Health Literature Plus, and Cochrane Library using the key words colorectal cancer, colorectal cancer screening, and Hispanic Americans.Findings: The studies reviewed highlighted various methods of culturally appropriate CRC screening promotion in Hispanic Americans. All studies showed an increase in fecal occult blood test (FOBT) completion and to some degree an improvement in overall CRC knowledge.Conclusions: The need for increased CRC screening and awareness studies in the Hispanic population is apparent. Future studies should use colonoscopy, a more sensitive test, to better evaluate CRC screening outcomes in Hispanics.Clinical Relevance: Participation in isolated studies involving FOBT does not necessarily lead to long-term understanding of CRC and the appropriate screening needed, hence the need for ongoing CRC education and promotion in primary care.Key wordsColorectal cancer, colorectal cancer screening, health promotion, Hispanic AmericansAccording to the American Cancer Society (2011), there were an estimated 141,210 newly diagnosed colorectal cancer cases in the United States in 201 1; approximately one third of these cases will lead to death. Colorectal cancer (CRC) is a significant international public health concern. Globally, it is the third and fourth most common cause of cancer among men and women, respectively (Center, Jemal, & Ward, 2009). Disease burden varies dramatically between countries and ethnicities, and is suggested to be dependent on a variety of factors, including availability and completion of CRC screening (Gellad & Provenzale, 2010). In the United States, colorectal cancer is the third leading cause of cancer-related death (American Cancer Society, 2011). Studies suggest that half of the deaths related to CRC can be avoided if individuals over age 50 years undergo routine screening Makoul et al., 2009). According to the American College of Gastroenterology's 2008 guidelines, the preferred CRC screening for individuals over the age of 50 is a colonoscopy every 10 years (Rex et al., 2009). Despite this fact, many Americans are not heeding the recommendation for preventive care. Over 20 million men and women ages 50 to 75 years have never undergone CRC screening (Richardson, Tai, Rim, Joseph, & Plesda, 201 1 ). One of the Healthy People 2020 objectives is to increase the prevalence of CRC screening to 70.5% (Richardson et al., 2011). An ethnic minority group that falls drastically short of meeting this objective is the Hispanic population. Only 29% percent of Hispanics over age 50 years compared with 44% of non-Hispanic Whites over age 50 years received some form of recent CRC screening Jandorf et al., 2010).Hispanics comprise the fastest growing minority group in the United States. Based on recent U.S. Census data they will represent 30% of the total population by the year 2050 (Ennis, Rios-Vargas, &· Albert, 2011). Colorectal cancer now ranks in the top three causes of cancerrelated death for both sexes, making it a major cause of mortality among U.S. Hispanics (Varela, Jandorf, & DuHamel, 2010).The purpose of this review is to synthesize the published research on the interventions used in the promotion of CRC screening in the Hispanic population. A review of the current literature will explore the question of whether providing culturally targeted interventions to promote knowledge and awareness of CRC screening in the Hispanic population results in increased screening rates. This information is of particular importance to all healthcare providers, including nurses and nurse practitioners, since screening is the most powerful tool for reducing CRC-related morbidity and mortality. …