title: Reluctance to screening colonoscopy in Arab Americans: a community based observational study.
abstract: To explore compliance of Arab-Americans to colorectal cancer (CRC) screening and identify the barriers for non-compliance. An observational community based study. Arab-American Friday prayer attendees' ≥50 years in three mosques in Dearborn, MI volunteered. Demographics, health insurance status, screening history, availability of a primary care physician (PCP) and the ability to communicate in Arabic were inquired. The responses were compared using a student t test between respondents who have had CRC screening with colonoscopy and those who have not had any screening tests. A p value of 0.05 or lower was considered statistically significant. Total number surveyed was 130. Average age is 64 years. Males were 76 % (99) and females 24 % (31). More than 50 % were Lebanese and 28 % were from Yemen. Majority had health insurance (89 %), and 86 % had a primary care physician of which 79 % of them spoke Arabic. Half of the participants had colonoscopy mostly for screening purposes. Fifty-eight (45 %) participants did not have CRC screening. Majority of the females (72.4 %) had colonoscopy compared to 46.8 % of the males (p value = 0.016). The mean length of stay in the U.S was 39.16 years in the colonoscopy group compared to 30.77 years in the non-screening group (p value = 0.006). Participants without a PCP did not have CRC screening (77.8 %) (p value = 0.005). Participants with a non-Arabic speaking PCP had more colonoscopy rates (77.3 %) compared to those with an Arabic speaking PCP (50 %) (p value = 0.027). More Lebanese had colonoscopy (71.9 %) compared to 25.7 % of the surveyed Yemenis (p value = 0.00). Discomfort, unawareness about CRC screening, and nonrecommendation by PCP were reported barriers. Arab-Americans have lower screening colonoscopy rates. Unfamiliarity of the importance of screening is a principal issue. Having a non-arabic speaking PCP is beneficial. Better education to this population about the benefits and ease of screening could increase adherence to screening for this population.
authors.affiliation: Department of Internal Medicine, Oakwood Hospital and Medical Center, 18101 Oakwood Blvd, Dearborn, MI 48124, USA. nizartalaat@gmail.com
authors.forename: Nizar
authors.initials: N
authors.lastname: Talaat
authors.forename: Walid
authors.initials: W
authors.lastname: Harb
mesh_terms: D018912:Arabs / Q000523:psychology / Q000706:statistics & numerical data*; D003113:Colonoscopy / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology; D055088:Early Detection of Cancer / Q000523:psychology*; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
references.citation: Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):389-94
references.pmid: 16492934
references.citation: Arch Intern Med. 2007 Feb 12;167(3):258-64
references.pmid: 17296881
references.citation: Am J Gastroenterol. 2009 Oct;104(10):2626-7; author reply 2628-9
references.pmid: 19806090
references.citation: CA Cancer J Clin. 2012 Jan-Feb;62(1):10-29
references.pmid: 22237781
references.citation: Women Health. 2004;39(3):63-77
references.pmid: 15256356
references.citation: J Cancer Surviv. 2012 Dec;6(4):372-8
references.pmid: 23054847
references.citation: World J Gastroenterol. 2009 Aug 14;15(30):3734-43
references.pmid: 19673013
references.citation: MMWR Surveill Summ. 2004 Jun 4;53(3):1-108
references.pmid: 15179359
references.citation: Ethn Dis. 2004 Winter;14(1):141-6
references.pmid: 15002934
references.citation: MMWR Suppl. 2012 Jun 15;61(2):51-6
references.pmid: 22695464
references.citation: Health Educ Behav. 2013 Aug;40(4):449-57
references.pmid: 23086556
references.citation: J Am Board Fam Med. 2012 May-Jun;25(3):308-17
references.pmid: 22570394
references.citation: J Gen Intern Med. 2003 Dec;18(12):1028-35
references.pmid: 14687262
references.citation: MMWR Morb Mortal Wkly Rep. 2007 Sep 14;56(36):932-6
references.pmid: 17851446
references.citation: J Community Health. 2011 Aug;36(4):517-24
references.pmid: 21107892
references.citation: Gastroenterol Nurs. 2012 Mar-Apr;35(2):93-8
references.pmid: 22472668
references.citation: J Gen Intern Med. 2009 Feb;24(2):211-7
references.pmid: 19067085
references.citation: Am J Med. 2001 Dec 1;111(8):593-601
references.pmid: 11755501
references.citation: Am J Clin Oncol. 2013 Aug;36(4):381-7
references.pmid: 22643567
references.citation: J Immigr Minor Health. 2013 Jun;15(3):472-5
references.pmid: 22752660
references.citation: Asian Pac J Cancer Prev. 2007 Jul-Sep;8(3):405-11
references.pmid: 18159978
references.citation: J Natl Med Assoc. 2011 Aug;103(8):681-8
references.pmid: 22046845
references.citation: Gastroenterol Res Pract. 2012;2012:483417
references.pmid: 22190913