title: Surveillance instructions and knowledge among African American colorectal cancer survivors.
abstract: BACKGROUND
  African Americans are less likely than other racial/ethnic groups to receive appropriate surveillance, an important component of care to achieve better long-term outcomes and well-being after colorectal cancer (CRC) treatment. This study explored survivors' understanding of surveillance instructions and purpose.
  
  
  METHODS
  Interviews with 60 African American CRC survivors were recorded and transcribed. Compliance with surveillance guidelines was defined by disease stage and self-reported tests. Four coders (blind to compliance status) independently reviewed transcripts. Frequency of themes was reported by compliance status.
  
  
  RESULTS
  Survivors (4 to 6 years postdiagnosis; women, 57%; age ≥ 65 years, 60%; rural location, 57%; early-stage disease, 62%) were 48% noncompliant. Most survivors reported receiving surveillance instructions from providers (compliant, 80%; noncompliant, 76%). There was variation in recommended frequency of procedures (eg, every 3 or 12 months) and in importance of surveillance stressed by physicians. Most survivors understood the need for follow-up (compliant, 87%; noncompliant, 79%). Lack of knowledge of/interest in surveillance was more common among noncompliant individuals (compliant, 32%; noncompliant, 52%).
  
  
  CONCLUSIONS
  Patients' limited understanding about the importance of CRC surveillance and procedures may negatively affect compliance with recommendations in African American CRC survivors. Clear and enhanced communications about post-treatment recommendations in this population are warranted.
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL; University of Maryland, College Park, MD; and Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Holt
authors.forename: Aquila
authors.initials: A
authors.lastname: Brown-Galvan
authors.forename: Temeika
authors.initials: T
authors.lastname: Fairley
authors.forename: Judith Lee
authors.initials: JL
authors.lastname: Smith
authors.forename: Arica
authors.initials: A
authors.lastname: White
authors.forename: Ingrid J
authors.initials: IJ
authors.lastname: Hall
authors.forename: Robert A
authors.initials: RA
authors.lastname: Oster
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Martin
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010817:Physician-Patient Relations; D012307:Risk Factors; D017741:Survivors