title: Knowledge and perceptions of colorectal cancer screening among urban African Americans.
abstract: OBJECTIVE
  To explore colorectal cancer (CRC) screening knowledge, attitudes, barriers, and preferences among urban African Americans as a prelude to the development of culturally appropriate interventions to improve screening for this group.
  
  
  METHODS
  Qualitative focus group study with assessment of CRC screening preferences.
  
  
  METHODS
  Community health center serving low-income African Americans.
  
  
  METHODS
  Fifty-five self-identified African Americans over 40 years of age.
  
  
  RESULTS
  Transcripts were analyzed using an iterative coding process with consensus and triangulation on final thematic findings. Six major themes were identified: (1) Hope--a positive attitude toward screening, (2) Mistrust--distrust that the system or providers put patients first, (3) Fear--fear of cancer, the system, and of CRC screening procedures, (4) Fatalism--the belief that screening and treatment may be futile and surgery causes spread of cancer, (5) Accuracy--a preference for the most thorough and accurate test for CRC, and (6) Knowledge--lack of CRC knowledge and a desire for more information. The Fear and Knowledge themes were most frequently noted in transcript theme counts. The Hope and Accuracy themes were crucial moderators of the influence of all barriers. The largest number of participants preferred either colonoscopy (33%) or home fecal occult blood testing (26%).
  
  
  CONCLUSIONS
  Low-income African Americans are optimistic and hopeful about early CRC detection and believe that thorough and accurate CRC screening is valuable. Lack of CRC knowledge and fear are major barriers to screening for this population along with mistrust, and fatalism.
authors.affiliation: Department of Family Medicine, University of Kansas Medical Center, Kansas City, Kan 66160, USA. agreiner@kumc.edu
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
authors.forename: Wendi
authors.initials: W
authors.lastname: Born
authors.forename: Nicole
authors.initials: N
authors.lastname: Nollen
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D014505:Urban Population