title: Optimism and barriers to colonoscopy in low-income Latinos at average risk for colorectal cancer.
abstract: OBJECTIVE
  Colorectal cancer (CRC) screening continues to be underused, particularly by Latinos. CRC and colonoscopy fear, worry, and fatalism have been identified as screening barriers in Latinos. The study purpose was to examine the relationship of optimism, fatalism, worry, and fear in the context of Latinos referred for CRC screening.
  
  
  METHODS
  Our sample included 251 Latinos between the ages of 50 and 83 years who had no personal or immediate family history of CRC, no personal history of gastrointestinal disorder, no colonoscopy in the past 5 years, and received a referral for a colonoscopy. Face-to-face interviews were performed, and data were analyzed using regression models.
  
  
  RESULTS
  Greater optimism (β = -1.72, p < 0.000), lower fatalism (β = 0.29, p < 0.01), and absence of family history of cancer (β = 1, p < 0.01) were associated with decreased worry about the colonoscopy. Being female (β = 0.85, p < 0.05) and born in the USA (β = 1.1, p < 0.01) were associated with greater worry about colonoscopy and the possibility of having CRC. Family history of cancer (β = 2.6, p < 0.01), female gender (β = 2.9, p < 0.000), not following the doctor's advice (β = 2.7, p < 0.01), and putting off medical problems (β = 1.9, p < 0.05) were associated with greater fear. In the multiple regression model, lower optimism (β = -0.09, p < 0.05), higher fatalism (β = 0.28, p < 0.01), and female gender (β = 0.9, p < 0.05) were associated with greater worry.
  
  
  CONCLUSIONS
  Interventions that address fatalism and promote optimistic beliefs may reduce worry among Latinos referred for colonoscopy. Interventions that alleviate colonoscopy fear because of family history of cancer particularly among Latino women may help improve distress about CRC screening.
authors.affiliation: Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, USA.|Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, USA.
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Efuni
authors.affiliation: Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, USA.|Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, USA.
authors.forename: Katherine N
authors.initials: KN
authors.lastname: DuHamel
authors.affiliation: Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Winkel
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, USA.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Starr
authors.affiliation: Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, USA.
authors.forename: Lina
authors.initials: L
authors.lastname: Jandorf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000208:ethnology; D001294:Attitude to Health / Q000208:ethnology*; D003113:Colonoscopy / Q000523:psychology / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067656:Optimism; D011203:Poverty / Q000208:ethnology*; D018570:Risk Assessment
keywords: cancer; colonoscopy; fear; oncology; optimism