Browsing by Subject "Colorectal cancer screening"

Now showing 1 - 5 of 5
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    African American patients' intent to screen for colorectal cancer: Do cultural factors, health literacy, knowledge, age and gender matter?
    (Johns Hopkins University Press, 2016-02) Brittain, Kelly; Christy, Shannon M.; Rawl, Susan M.; Department of Psychology, School of Science
    African Americans have higher colorectal cancer (CRC) mortality rates. Research suggests that CRC screening interventions targeting African Americans be based upon cultural dimensions. Secondary analysis of data from African-Americans who were not up-to-date with CRC screening (n=817) was conducted to examine: 1) relationships among cultural factors (i.e., provider trust, cancer fatalism, health temporal orientation (HTO)), health literacy, and CRC knowledge; 2) age and gender differences; and 3) relationships among the variables and CRC screening intention. Provider trust, fatalism, HTO, health literacy and CRC knowledge had significant relationships among study variables. The FOBT intention model explained 43% of the variance with age and gender being significant predictors. The colonoscopy intention model explained 41% of the variance with gender being a significant predictor. Results suggest that when developing CRC interventions for African Americans, addressing cultural factors remain important, but particular attention should be given to the age and gender of the patient.
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    Layperson Views about the Design and Evaluation of Decision Aids: A Public Deliberation
    (Sage, 2021-07) Schwartz, Peter H.; O’Doherty, Kieran C.; Bentley, Colene; Schmidt, Karen K.; Burgess, Michael M.; Medicine, School of Medicine
    Purpose: We carried out the first public deliberation to elicit lay input regarding guidelines for the design and evaluation of decision aids, focusing on the example of colorectal ("colon") cancer screening. Methods: A random, demographically stratified sample of 28 laypeople convened for 4 days, during which they were informed about key issues regarding colon cancer, screening tests, risk communication, and decision aids. Participants then deliberated in small and large group sessions about the following: 1) What information should be included in all decision aids for colon screening? 2) What risk information should be in a decision aid and how should risk information be presented? 3) What makes a screening decision a good one (reasonable or legitimate)? 4) What makes a decision aid and the advice it provides trustworthy? With the help of a trained facilitator, the deliberants formulated recommendations, and a vote was held on each to identify support and alternative views. Results: Twenty-one recommendations ("deliberative conclusions") were strongly supported. Some conclusions matched current recommendations, such as that decision aids should be available for use with and without providers present (conclusions 1-4) and should support informed choice (conclusion 9). Some conclusions differed from current recommendations, at least in emphasis-for example, that decision aids should disclose cost of screening (conclusion 11) and should be kept simple and understandable (conclusion 14). Deliberants recommended that decision aids should disclose the baseline risk of getting colon cancer (conclusions 15, 17). Limitations: Single location and medical decision. Conclusions: Guidelines for design of decision aids should consider putting a greater focus on disclosing cost and keeping decision aids simple, and they possibly should recommend disclosing less extensive amounts of quantitative information than currently recommended.
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    Masculinity Beliefs and Colorectal Cancer Screening in Male Veterans
    (American Psychological Association, 2017-10) Christy, Shannon M.; Mosher, Catherine E.; Rawl, Susan M.; Haggstrom, David A.; Psychology, School of Science
    As the third most common cause of cancer death among United States men, colorectal cancer (CRC) represents a significant threat to men's health. Although adherence to CRC screening has the potential to reduce CRC mortality by approximately half, men's current rates of adherence fall below national screening objectives. In qualitative studies, men have reported forgoing screenings involving the rectum (e.g., colonoscopy) due to concern about breaching masculinity norms. However, the extent to which masculinity beliefs predict men's CRC screening adherence has yet to be examined. The current study tested the hypothesis that greater endorsement of masculinity beliefs (i.e., self-reliance, risk-taking, heterosexual self-presentation, and primacy of work) would be associated with a lower likelihood of adherence to CRC screening with any test and with colonoscopy specifically. Participants were 327 men aged 51-75 at average risk for CRC who were accessing primary care services at a Midwestern Veterans Affairs Medical Center. Contrary to hypotheses, masculinity beliefs did not predict CRC screening outcomes in hierarchical regression analyses that controlled for demographic predictors of screening. Although results are largely inconsistent with masculinity theory and prior qualitative findings, further research is needed to determine the degree to which findings generalize to other populations and settings.
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    Relationships between masculinity beliefs and colorectal cancer screening in male veterans
    (2015) Christy, Shannon M.; Mosher, Catherine E.; Rawl, Susan M.; Rand, Kevin L.; Haggstrom, David A.
    Men’s adherence to masculinity norms has been implicated as a risk factor for unhealthy behaviors (e.g., drinking to intoxication, having unprotected sex with multiple, simultaneous partners) and lack of engagement in healthy behaviors (e.g., blood pressure screening, cholesterol screening, wearing protective clothing while in the sun, receipt of annual medical and dental exams) (Boman & Walker, 2010; Courtenay, 2000a, 2000b, 2011; Hammond, Matthews, & Corbie-Smith, 2010; Iwamoto, Cheng, Lee, Takamatsu, & Gordon, 2011; Locke & Mahalik, 2005; Mahalik, Lagan, & Morrison, 2006; Mahalik et al., 2003; Nicholas, 2000; Pachankis, Westmaas, & Dougherty, 2011; Pleck, Sonenstein, & Ku, 1993; Wade, 2009). Masculinity has been defined as behaviors, beliefs, and personality characteristics associated more often with men than women as well as characteristics and behaviors that society prescribes and reinforces in men (Thompson, Pleck, & Ferrera, 1992). Rooted in geographical, cultural, and temporal environments, diverse masculinities have emerged throughout the United States and the world (Connell, 1995; Courtenay, 2011). Traditional masculinity beliefs and behaviors in the United States include the sturdy oak (men should be tough, self-reliant, stoic, and confident), no sissy stuff (men should avoid feminine characteristics and behaviors), the big wheel (men should strive for success and status), and give ‘em hell (men should embrace aggressiveness, daring, and violence) (Brannon, 1976). Numerous qualitative studies have suggested that some men find cancer screening examinations involving the rectum (i.e., endoscopy for colorectal cancer [CRC] screening or digital rectal examination [DRE] for prostate cancer screening) an affront to their masculinity (see Table 1 for quotations from these studies) (Bass et al., 2011; Beeker, Kraft, Southwell, & Jorgensen, 2000; Getrich et al., 2012; Goldman, Diaz, & Kim, 2009; Harvey & Alston, 2011; Holt et al., 2009; Jilcott Pitts et al., 2013; Jones, Devers, Kuzel, & Woolf, 2010; Rivera-Ramos & Buki, 2011; Thompson, Reeder, & Abel, 2011; Wackerbarth, Peters, & Haist, 2005; Winterich et al., 2009). However, to the author’s knowledge, no quantitative studies have considered the role of masculinity in CRC screening adherence. Unfortunately, current CRC screening rates fall below the 70.5% Healthy People 2020 screening objective (U.S. Department of Health and Human Services, 2012).Research is needed to better understand relationships between men’s masculinity norms and CRC screening adherence so that interventions may be developed to reduce barriers to screening, improve screening rates, and, ultimately, decrease men’s mortality from CRC. The present study will address this gap in the literature by examining the masculinity norms and CRC screening adherence of male veterans aged 51-75 years who are at average CRC risk (Levin et al., 2008). First, the prevalence of CRC, its risk factors and warning signs as well as CRC screening techniques, screening rates, and characteristics of individuals who are adherent and non-adherent to CRC screening guidelines are summarized. Next, the concept of masculinity, theoretical and empirical support for studying masculinity norms within the context of CRC screening, and potential relationships between masculinity norms and colorectal cancer screening behaviors are described. Finally, the study methods, results, and future directions and limitations of this research are described.
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    Risk of Advanced Neoplasia Using the National Cancer Institute’s Colorectal Cancer Risk Assessment Tool
    (Oxford University Press, 2017-01) Imperiale, Thomas F.; Yu, Menggang; Monahan, Patrick O.; Stump, Timothy E.; Tabbey, Rebeka; Glowinski, Elizabeth; Ransohoff, David F.; Medicine, School of Medicine
    Background: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute’s (NCI’s) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons. Methods: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy. We measured medical and family history, lifestyle information, and physical measures and calculated each person’s future CRC risk using the NCI tool’s logistic regression equation. We related quintiles of future CRC risk to the current risk of advanced neoplasia (sessile serrated polyp or tubular adenoma ≥ 1 cm, a polyp with villous histology or high-grade dysplasia, or CRC). All statistical tests were two-sided. Results: For 4457 (98.5%) with complete data (mean age = 57.2 years, SD = 6.6 years, 51.7% women), advanced neoplasia prevalence was 8.26%. Based on quintiles of five-year estimated absolute CRC risk, current risks of advanced neoplasia were 2.1% (95% confidence interval [CI] = 1.3% to 3.3%), 4.8% (95% CI = 3.5% to 6.4%), 6.4% (95% CI = 4.9% to 8.2%), 10.0% (95% CI = 8.1% to 12.1%), and 17.6% (95% CI = 15.5% to 20.6%; P < .001). For quintiles of estimated 10-year CRC risk, corresponding current risks for advanced neoplasia were 2.2% (95% CI = 1.4% to 3.5%), 4.8% (95% CI = 3.5% to 6.4%), 6.5% (95% CI = 5.0% to 8.3%), 9.3% (95% CI = 7.5% to 11.4%), and 18.4% (95% CI = 15.9% to 21.1%; P < .001). Among persons with an estimated five-year CRC risk above the median, current risk for advanced neoplasia was 12.8%, compared with 3.7% among those below the median (relative risk = 3.4, 95 CI = 2.7 to 4.4). Conclusions: The NCI’s Risk Assessment Tool, which estimates future CRC risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving CRC screening efficiency among average-risk persons.