Cancer and colorectal cancer: Knowledge, beliefs, and screening preferences of a diverse patient population

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States, with African Americans having the highest incidence and mortality of all racial and ethnic groups. CRC screening is widely recommended but remains underused, especially in minority populations. This study's purpose was to enhance our understanding of factors contributing to low screening rates among patients from a variety of racial and ethnic groups. Methods: We conducted individual interviews with 30 participants, ages 50 or above, with an equal number of African Americans, Hispanics, and whites at a university-based family medicine clinic. We used open-ended interviewing techniques to elicit patient knowledge and beliefs regarding cancer, CRC, screening, and CRC screening tests. Results: All groups, but particularly minority groups, lack knowledge of cancer, CRC, and screening. They did not understand the concept of screening, had difficulty listing common cancer and CRC screening tests, and had trouble understanding simplified medical terms and procedure names. Patients were hopeful about the benefit of early cancer diagnosis but remained reluctant to get tested if they are symptom free. Conclusions: Lack of understanding of cancer, screening, and routine terminology is a barrier to CRC screening, especially among minority groups. Effective communication strategies that address these issues may help increase CRC screening rates.