Skip to main content
PMC home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Sep;95(9):806–812.

Colorectal cancer screening among African Americans: the importance of physician recommendation.

Vicky Taylor 1, Daniel Lessler 1, Kathy Mertens 1, Shin-Ping Tu 1, Alton Hart 1, Nadine Chan 1, Jianfen Shu 1, Beti Thompson 1
PMCID: PMC2594456  PMID: 14527047

Abstract

INTRODUCTION: African Americans have higher colorectal cancer incidence and mortality rates than whites. They are also more likely to be diagnosed with late-stage disease and less likely to survive for at least five years after diagnosis. Lack of adherence to colorectal cancer screening recommendations has previously been found to be associated with lower income, lower educational level, and racial/ethnic minority status. METHODS: One hundred-fifty African-American patients (aged 50-79 years) of an inner city hospital, were surveyed by mail and telephone in early 2002. Seventy-six patients completed the survey, and data from 74 surveys were analyzed. RESULTS: Approximately one-half (55%) of the respondents reported having received a fecal occult blood test (FOBT) in the last 12 months, sigmoidoscopy in the last five years, or colonoscopy in the last 10 years. Thirty-nine percent of the survey participants reported never having received a physician recommendation for FOBT, 60% reported never having received a recommendation for sigmoidoscopy, and 57% reported never having received a recommendation for colonoscopy. Previous physician recommendation was strongly associated (p < 0.001) with levels of FOBT, sigmoidoscopy, and colonoscopy use. DISCUSSION: Future studies should examine factors that influence primary care physicians' decision-making about ordering colorectal cancer screening tests, as well as patients' decision-making regarding adherence to physician recommendations.

Full text

PDF
806

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baquet C. R., Commiskey P. Colorectal cancer epidemiology in minorities: a review. J Assoc Acad Minor Phys. 1999;10(3):51–58. [PubMed] [Google Scholar]
  2. Centers for Disease Control and Prevention (CDC) Screening for colorectal cancer--United States, 1997. MMWR Morb Mortal Wkly Rep. 1999 Feb 19;48(6):116–121. [PubMed] [Google Scholar]
  3. Hawley S. T., Earp J. A., O'Malley M., Ricketts T. C. The role of physician recommendation in women's mammography use: is it a 2-stage process? Med Care. 2000 Apr;38(4):392–403. doi: 10.1097/00005650-200004000-00006. [DOI] [PubMed] [Google Scholar]
  4. Hoffman-Goetz L., Breen N. L., Meissner H. The impact of social class on the use of cancer screening within three racial/ethnic groups in the United States. Ethn Dis. 1998 Winter;8(1):43–51. [PubMed] [Google Scholar]
  5. Landis S. H., Murray T., Bolden S., Wingo P. A. Cancer statistics, 1999. CA Cancer J Clin. 1999 Jan-Feb;49(1):8-31, 1. doi: 10.3322/canjclin.49.1.8. [DOI] [PubMed] [Google Scholar]
  6. Lemon S., Zapka J., Puleo E., Luckmann R., Chasan-Taber L. Colorectal cancer screening participation: comparisons with mammography and prostate-specific antigen screening. Am J Public Health. 2001 Aug;91(8):1264–1272. doi: 10.2105/ajph.91.8.1264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Lipkus I. M., Rimer B. K., Lyna P. R., Pradhan A. A., Conaway M., Woods-Powell C. T. Colorectal screening patterns and perceptions of risk among African-American users of a community health center. J Community Health. 1996 Dec;21(6):409–427. doi: 10.1007/BF01702602. [DOI] [PubMed] [Google Scholar]
  8. Mandelson M. T., Curry S. J., Anderson L. A., Nadel M. R., Lee N. C., Rutter C. M., LaCroix A. Z. Colorectal cancer screening participation by older women. Am J Prev Med. 2000 Oct;19(3):149–154. doi: 10.1016/s0749-3797(00)00193-8. [DOI] [PubMed] [Google Scholar]
  9. Phillips K. A., Kerlikowske K., Baker L. C., Chang S. W., Brown M. L. Factors associated with women's adherence to mammography screening guidelines. Health Serv Res. 1998 Apr;33(1):29–53. [PMC free article] [PubMed] [Google Scholar]
  10. Read T. E., Kodner I. J. Colorectal cancer: risk factors and recommendations for early detection. Am Fam Physician. 1999 Jun;59(11):3083–3092. [PubMed] [Google Scholar]
  11. Rex D. K., Johnson D. A., Lieberman D. A., Burt R. W., Sonnenberg A. Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology. American College of Gastroenterology. Am J Gastroenterol. 2000 Apr;95(4):868–877. doi: 10.1111/j.1572-0241.2000.02059.x. [DOI] [PubMed] [Google Scholar]
  12. Ries L. A., Wingo P. A., Miller D. S., Howe H. L., Weir H. K., Rosenberg H. M., Vernon S. W., Cronin K., Edwards B. K. The annual report to the nation on the status of cancer, 1973-1997, with a special section on colorectal cancer. Cancer. 2000 May 15;88(10):2398–2424. doi: 10.1002/(sici)1097-0142(20000515)88:10<2398::aid-cncr26>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  13. Skinner C. S., Arfken C. L., Sykes R. K. Knowledge, perceptions, and mammography stage of adoption among older urban women. Am J Prev Med. 1998 Jan;14(1):54–63. doi: 10.1016/s0749-3797(97)00008-1. [DOI] [PubMed] [Google Scholar]
  14. Stoddard A. M., Rimer B. K., Lane D., Fox S. A., Lipkus I., Luckmann R., Avrunin J. S., Sprachman S., Costanza M., Urban N. Underusers of mammogram screening: stage of adoption in five U.S. subpopulations. The NCI Breast Cancer Screening Consortium. Prev Med. 1998 May-Jun;27(3):478–487. doi: 10.1006/pmed.1998.0310. [DOI] [PubMed] [Google Scholar]
  15. Troisi R. J., Freedman A. N., Devesa S. S. Incidence of colorectal carcinoma in the U.S.: an update of trends by gender, race, age, subsite, and stage, 1975-1994. Cancer. 1999 Apr 15;85(8):1670–1676. [PubMed] [Google Scholar]
  16. Vernon S. W. Participation in colorectal cancer screening: a review. J Natl Cancer Inst. 1997 Oct 1;89(19):1406–1422. doi: 10.1093/jnci/89.19.1406. [DOI] [PubMed] [Google Scholar]
  17. Vernon S. W. Participation in colorectal cancer screening: a review. J Natl Cancer Inst. 1997 Oct 1;89(19):1406–1422. doi: 10.1093/jnci/89.19.1406. [DOI] [PubMed] [Google Scholar]
  18. Winawer S. J., Fletcher R. H., Miller L., Godlee F., Stolar M. H., Mulrow C. D., Woolf S. H., Glick S. N., Ganiats T. G., Bond J. H. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology. 1997 Feb;112(2):594–642. doi: 10.1053/gast.1997.v112.agast970594. [DOI] [PubMed] [Google Scholar]
  19. Wolf R. L., Zybert P., Brouse C. H., Neugut A. I., Shea S., Gibson G., Lantigua R. A., Basch C. E. Knowledge, beliefs, and barriers relevant to colorectal cancer screening in an urban population: a pilot study. Fam Community Health. 2001 Oct;24(3):34–47. doi: 10.1097/00003727-200110000-00006. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES