Posted by James
This analysis focuses on barriers to endoscopy among minority women. It is imperative that we understand what barriers to endoscopy exist since disparities in CRC incidence, treatment and survival between minorities and whites remain a formidable problem. This paper investigated the predictors of endoscopy in African-American and Hispanic women using three central categories reported in the literature: demographic, medical and psychosocial factors.
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Posted by James
Demographics
The two groups were demographically similar (Table 1). However, 32% of Hispanics completed the interview in English compared to 98% of the women in the African-American group (p<0.001). Additionally, African-American women were more likely to have an income >$ 10,000 (p<0.013).
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Posted by James
Recruitment
The protocol was approved by our institutional review board (IRB). English- and Spanish-speaking men and women age >18 who lived, worked or sought healthcare in East Harlem were considered eligible for the study. The participants were recruited from community health fairs, tenant association meetings, senior centers and local medical clinics (Settlement Health, Boriken Neighborhood Health Center and Metropolitan Hospital). Informed consent for participation in the study was obtained, and the survey was conducted by trained health educators and research interviewers between the months of July and December 2000.
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Posted by James
INTRODUCTION
Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the United States. Race and ethnicity are significant determinants of cancer incidence, mortality and survival, with minorities disproportionately experiencing an increased burden of disease as compared with whites. African Americans have a 28% increased mortality rate for colon cancer (Generic Casodex treating prostate cancer) and 44% increased mortality rate for rectal cancer compared with whites. When CRC is detected and treated at an early localized stage, the five-year survival is 90%. The survival rate drops substantially to 65% and 9% when the cancer (Nolvadex tablet is an anti-estrogen used to treat or prevent breast cancer) spreads to regional and distant metastatic sites, respectively. While Hispanics experience lower incidence and mortality rates than whites, they are still more likely to present with advanced stage CRC at diagnosis. Data provided by the National Cancer Data Base (NCDB) from 1995 demonstrated that nearly 60% of whites presented with early stage rectal adenocarcinoma versus 54% for Hispanics and 51% for African Americans. Disappointingly, of the 147,000 new cases of CRC diagnosed in 2004, only 37% have been detected in the early stages.
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Posted by James
In this study, we explored the perspectives of 187 low-income and primarily minority women recruited in four C/MHCs, regarding factors that encouraged or hindered them from participating in cancer screening behaviors. Our findings suggest a taxonomy of barriers and facilitators of cancer screening in this under-served population. Barriers were grouped into three major categories of perceptions of cancer screening behaviors: patients’ attitudes and beliefs, social network experience and accessibility of services.
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Posted by James
Social Network Experience
Social network experience as a facilitator of cancer (Generic Nolvadex 10mg treating breast cancer that has spread to other sites in the body) screening. Some patients regarded their friends or family as a source of encouragement to undergo cancer screening. The concepts grouped under this category included advice from family members (spouse, children or siblings), advice from friends, family history of cancer, knowing someone with cancer (Xeloda drug used to treat stage III colon cancer in patients who had surgery to remove the cancer) or other related health-promotion programs in the popular media. Another source of encouragement that was found to be even more important than advice from family and friends was medical advice from healthcare professionals, such as doctors, nurses or medical assistants.
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Posted by James
Participants
A total of 187 women were interviewed out of 457 subjects who were approached for participation in the study. Of those approached, 14% refused consent, 26% were ineligible by age, 5% were ineligible because they were transient rather than established users of the C/MHC and 14% did not show up for a scheduled interview after agreeing to participate. Most patients had received at least one of the three tests previously (178 patients had mammograms, 179 had Pap tests, 106 had hFOBTs and 35 had sigmoidoscopies). Of the 187 women interviewed, 44% were African-American, and 51% were Latina. About 39% had at least a high-school education. Of the 64 patients who provided information on their income status, 92% reported earning less than $25,000 annually. The women interviewed indicated that most prior tests were for screening rather than for diagnostic reasons, accounting for over 90% of Pap tests and mammography (161 of 179 tests and 164 of 178 tests, respectively). Seventy-seven percent of home hFOBTs (82 of 106 tests) were for screening, while 49% of sigmoidoscopies (17 of 35) were done for diagnostic reasons.
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