Disparities/Minority Health

Colorectal cancer screening rates are low among Latinos and people with little education

Colorectal cancer screening is recommended for individuals over the age of 50. However, Latinos and individuals with little education are less likely to be screened for colorectal cancer, according to a study supported by the Agency for Healthcare Research and Quality (HS10299). Efforts to educate these two groups about the importance of colorectal cancer screening are needed to reduce disparities in awareness and use of colorectal cancer screening tests, conclude the researchers.

Researchers assessed the demographics, acculturation, and health literacy regarding colorectal cancer screening among 136 Latino, white, or black patients. Most of the Latinos had low acculturation. The researchers used the Short Test of Functional Health Literacy in Adults (STOFHLA) to assess whether patients had heard of colorectal cancer and screening via fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy. The STOFHLA also asked at what age a person should be tested and how often for various tests.

In the primary care clinics sampled in the study, 42 percent of the patients had STOFHLA scores in the inadequate or marginal range. Lower scoring patients were more likely to be Latino, have less than an eighth grade education, and be poor and uninsured. Functional health literacy as assessed by the STOFHLA was not an independent predictor of colorectal cancer screening knowledge, beliefs, attitudes, or behavior. Latino ethnicity and low education emerged as stronger predictors of less knowledge and fewer screening tests. Another important finding was the 90 percent of patients who said that they would undergo screening if their physician recommended it or had been screened because their doctor encouraged it.

More details are in "Literacy and knowledge, attitudes, and behavior about colorectal cancer screening," by Carmen E. Guerra, M.D., F.A.C.P., Francisco Dominguez, and Judy A. Shea, Ph.D., in the October/November 2005 Journal of Health Communication 10, pp. 651-663.

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