Racial differences in colorectal cancer screening practices and knowledge within a low-income population.
BACKGROUND
Although colorectal cancer (CRC) is the third leading cause of cancer death among US women and is particularly deadly among African Americans, CRC screening rates remain low. Within a low-income population of women, the authors examined racial differences in practices, knowledge, and barriers related to CRC screening.


METHODS
Face-to-face interviews were conducted with 941 women (white, n= 186; African American, n= 755) older than age 50 years who were living in subsidized housing communities in 11 cities in North and South Carolina. Women were asked questions about their CRC screening history and their knowledge and beliefs concerning CRC screening.


RESULTS
Half (49%) of the women interviewed were within CRC screening guidelines, and this did not vary by race (P= .17). However, African American women were half as likely as white women to report having had a screening colonoscopy within the past 10 years (odds ratio [OR], 0.46; P< .001). Awareness of tests for CRC was low overall (39%) and was lower among African Americans than whites (OR, 0.44; P< .001). Compared with white women, African American women were less likely to report embarrassment as a barrier (OR, 0.59; P= .008) and more likely to report lack of insurance coverage (OR, 1.75; P= .098).


CONCLUSIONS
Efforts must continue to increase women's knowledge of both CRC screening tests and colon cancer risk factors. Among these low-income women, routine encounters with the healthcare system may present opportunities to reduce deficits in CRC knowledge and to improve overall CRC screening rates.
Division of Health Services Management and Policy, College of Public Health, Ohio State University, Columbus, Ohio 43210, USA. mcalearney.1@osu.edu
Ann Scheck
AS
McAlearney
Katherine W
KW
Reeves
Stephanie L
SL
Dickinson
Kimberly M
KM
Kelly
Cathy
C
Tatum
Mira L
ML
Katz
Electra D
ED
Paskett
D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D044465:White People; D001741:Black or African American