Promoting Colorectal Cancer Screening Among Haitian Americans

Background: Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns. Methods: In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research. Results: Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of the curability of colorectal cancer, preventive practices, and preferred sources of information among Haitian Americans and other ethnic subgroups of U.S. Blacks. Awareness of colorectal cancer screening tests, risk perception, healthcare provider recommendation, and self-reported use of screening are suboptimal among Haitian Americans and other subgroups. In preliminary quantitative studies, Haitian immigrants have been found to have lower colorectal cancer screening rates than other groups such as African Americans. Conclusions: Culturally appropriate educational interventions are needed to encourage Haitian American adults aged \u3e 50 years to undergo screening for colorectal cancer and to ensure that they are well informed about the value of healthy eating and physical activity

Diabetes status and being up-to-date on colorectal cancer screening, 2012 Behavioral Risk Factor Surveillance System

INTRODUCTION: Although screening rates for colorectal cancer are increasing, 22 million Americans are not up-to-date with recommendations. People with diabetes are an important and rapidly growing group at increased risk for colorectal cancer. Screening status and predictors of being up-to-date on screening are largely unknown in this population. METHODS: This study used logistic regression modeling and data from the 2012 Behavioral Risk Factor Surveillance System to examine the association between diabetes and colorectal cancer screening predictors with being up-to-date on colorectal cancer screening according to criteria of the US Preventive Services Task Force for adults aged 50 or older. State prevalence rates of up-to-date colorectal cancer screening were also calculated and mapped. RESULTS: The prevalence of being up-to-date with colorectal cancer screening for all respondents aged 50 or older was 65.6%; for respondents with diabetes, the rate was 69.2%. Respondents with diabetes were 22% more likely to be up-to-date on colorectal cancer screening than those without diabetes. Among those with diabetes, having a routine checkup within the previous year significantly increased the odds of being up-to-date on colorectal cancer screening (odds ratio, 1.90). Other factors such as age, income, education, race/ethnicity, insurance status, and history of cancer were also associated with up-to-date status. CONCLUSION: Regardless of diabetes status, people who had a routine checkup within the past year were more likely to be up-to-date than people who had not. Among people with diabetes, the duration between routine checkups may be of greater importance than the frequency of diabetes-related doctor visits. Continued efforts should be made to ensure that routine care visits occur regularly to address the preventive health needs of patients with and patients without diabetes

Risk Factors for Colorectal Cancer in Korea: A Population-Based Retrospective Cohort Study

PURPOSE: The incidence of colorectal cancer in Korea has recently increased, making it the second most common cancer in men and the third most common cancer in women. Risk factors for colorectal cancer have been studied worldwide, but risk factors specific for the Korean population have not been established. In this study, we investigated incidence trends and risk factors of colorectal cancer in Korea. METHODS: A total of 8,846,749 subjects were included. Colorectal cancer incidence was investigated using Korea National Health Insurance Service claim data from 2004 to 2014. Colorectal cancer diagnoses were obtained by evaluating colorectal cancer diagnostic codes and the cancer registry for cost sharing. Risk factor identification for colorectal cancer was obtained from National Health Examination data from 2004 to 2005. Cox proportional hazard model statistical analysis was used to determine risk factors of colorectal cancer. RESULTS: The incidence of colorectal cancer gradually increased from 2006 to 2014 (from 45.4/100,000 to 54.5/100,000). There was a predominance among men (1.47:1), but incidence trends were similar in both sexes. Old age, high body mass index, and no history of colonoscopy were identified as risk factors in both sexes. High fasting blood glucose, familial history of cancer, frequent alcohol intake, and current smoker were identified as risk factors, especially in men. CONCLUSION: The incidence of colorectal cancer has been increasing in Korea. Colonoscopy screening was a protective factor for colorectal cancer, and active use of colonoscopy may reduce incidence. Early diagnosis and care are important, particularly for the high-risk group.ope

Diet and Food chemicals increasing the risk of colorectal cancer – literature review

Colorectal cancer is a common form of cancer nowadays. There are many risk factors in the pathogenesis of colorectal cancer. The malignant proliferation is caused by one or more genetic mutations, which activate oncogenes and deactivate tumor suppressor genes. Some factors cannot be changed, such as a person\u27s age or family history. An essential aspect in the pathogenesis of colorectal cancer is the choice of lifestyles, such as a high-fat diet, smoking, and excess alcohol. Carcinogens can be either natural or chemical. The mechanisms by which carcinogens initiate tumor formation are genetic or non-genotoxic. The most common form of colorectal cancer is found in people who ingest chemicals that, once ingested, reach the large intestine, thus causing malignant lesions. The Western diet and the metabolic syndrome are risk factors for colorectal cancer, due to gut microbiota changes and low-grade chronic inflammation. Among the most important diet carcinogens are nitrosamines, hydrazines, organophosphates, acetaldehyde, and heterocyclic amines. Screening programs, especially among people over 50 years of age, and with multiple risk factors are extremely important in detecting colorectal cancers in the early stages and in improving the long-term prognosis in such patients

Prev Chronic Dis

IntroductionAlthough screening rates for colorectal cancer are increasing, 22 million Americans are not up-to-date with recommendations. People with diabetes are an important and rapidly growing group at increased risk for colorectal cancer. Screening status and predictors of being up-to-date on screening are largely unknown in this population.MethodsThis study used logistic regression modeling and data from the 2012 Behavioral Risk Factor Surveillance System to examine the association between diabetes and colorectal cancer screening predictors with being up-to-date on colorectal cancer screening according to criteria of the US Preventive Services Task Force for adults aged 50 or older. State prevalence rates of up-to-date colorectal cancer screening were also calculated and mapped.ResultsThe prevalence of being up-to-date with colorectal cancer screening for all respondents aged 50 or older was 65.6%; for respondents with diabetes, the rate was 69.2%. Respondents with diabetes were 22% more likely to be up-to-date on colorectal cancer screening than those without diabetes. Among those with diabetes, having a routine checkup within the previous year significantly increased the odds of being up-to-date on colorectal cancer screening (odds ratio, 1.90). Other factors such as age, income, education, race/ethnicity, insurance status, and history of cancer were also associated with up-to-date status.ConclusionRegardless of diabetes status, people who had a routine checkup within the past year were more likely to be up-to-date than people who had not. Among people with diabetes, the duration between routine checkups may be of greater importance than the frequency of diabetes-related doctor visits. Continued efforts should be made to ensure that routine care visits occur regularly to address the preventive health needs of patients with and patients without diabetes.T32 GM081740/GM/NIGMS NIH HHS/United StatesT32-GM081740/GM/NIGMS NIH HHS/United States26851338PMC474744

A REVIEW OF TREATMENT, RISK FACTORS, AND INCIDENCE OF COLORECTAL CANCER

Colorectal cancer (CRC) is considered as the third most frequent cancer in the world and the incidence increases with increasing age. CRC accounts for nearly 9 % of all cancer incidence, with an estimated 1.4 million cases happening in 2012. The aim of this paper is to provide a review of incidence, risk factors, screening strategies, and treatment of colorectal cancer. We searched the studies in five English databases, including Web of Science, PubMed, Scopus, EMBASE, and Google Scholar with no limitation in publication time to find all papers regarding colorectal cancers. Papers with any language were included in the first step of search if they had an English abstract. We used the following words and terms including colorectal cancer, treatment, risk factor, diagnosis, chemotherapy, radiotherapy, surgery. Geographical variations and different time courses in the CRC incidence indicate that environmental factors and lifestyle are major factors in the development of this disease. The main preventable risk factors for CRC are nutrition, a high-fat diet, a low-fiber diet, obesity and physical inactivity, smoking and alcohol consumption, aspirin and nonsteroidal anti-inflammatory drugs, and some non-preventable risk factors such as age, gender, race, and diabetes mellitus. Colonoscopy remains the study of choice to diagnose colorectal cancer. Prior to any treatment, CT imaging of chest, abdomen and pelvis with contrast is needed for staging the patient’s CRC. The preferred option for localized colorectal cancer is surgery (etc, laparoscopic surgery, colostomy for rectal cancer); whereas the adjuvant chemotherapy is generally recommended for patients with lymph node metastases. Targeted treatment of colorectal cancer by monoclonal antibodies are important bioengineered proteins that can help the body's natural immune response to detect, attack, and kill cancer cells. Monoclonal antibodies may be used alone or in combination with other treatments such as chemotherapy. CRC accounts an important health problem worldwide that is estimated to increase because of the growth and aging of the population, and because of the adoption of at-risk manners and lifestyles, particularly in economically less developed countries. Screening has been confirmed to significantly decrease mortality and can prevent the onset of the disease. More international efforts are required to situate into practice targeted prevention approaches that might reduce the burden of CRC worldwide

Screening and Surveillance of the Gastrointestinal Tract

This thesis aims to optimise prevention programmes for gastric- and colorectal cancer. The first part consists of studies on surveillance of premalignant gastric lesions. Prospectively, we evaluated current guidelines on the proper identification of patients with premalignant gastric lesions that deserve further follow up. After one extra gastro endoscopy – were guidelines would advise to stop further surveillance - it appeared that a considerable part would have an indication for further surveillance after all. We investigated several possibilities for the improvement of surveillance programmes. To name; the use of a new endoscopy technique, evaluating risk factors within patients (such as smoking and a family history of gastric cancer), and the new possibility of detecting the most important risk factor for the occurrence of gastric cancer – Helicobacter Pylori bacterium – in the fecal test used in colorectal cancer screening. The second part of this thesis consist of studies on colorectal cancer screening. First, the video capsule was used to determine prevalence rates of several abnormalities (benign or malignant) in a general population. Further, a comprehensive retrospective study in 20 European countries was performed on the incidence of colorectal cancer over time within different age groups. This showed that the incidence is increasing mostly at younger ages. Lastly, literature studies were performed in order to further improve and innovate the current colorectal cancer screening programme. We showed that the use of anticoagulants do not affect the fecal blood test used in screening. Also, the video capsule appeared to be a good alternative beside colonoscopy.<br/

Factors Associated with Colorectal Cancer Screening among Younger African American Men: A Systematic Review

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age \u3c 50) African American men’s intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men’s screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men\u27s knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies’ methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions

Barriers to colorectal cancer screening in community health centers: A qualitative study

<p>Abstract</p> <p>Background</p> <p>Colorectal cancer screening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers.</p> <p>Methods</p> <p>We identified twenty-three outpatients who were eligible for colorectal cancer screening and their 10 primary care physicians. Using in-depth semi-structured interviews, we asked patients to describe factors influencing their screening decisions. For each unscreened patient, we asked his or her physician to describe barriers to screening. We conducted patient interviews in English (n = 8), Spanish (n = 2), Portuguese (n = 5), Portuguese Creole (n = 1), and Haitian Creole (n = 7). We audiotaped and transcribed the interviews, and then identified major themes in the interviews.</p> <p>Results</p> <p>Four themes emerged: 1) Unscreened patients cited lack of trust in doctors as a barrier to screening whereas few physicians identified this barrier; 2) Unscreened patients identified lack of symptoms as the reason they had not been screened; 3) A doctor's recommendation, or lack thereof, significantly influenced patients' decisions to be screened; 4) Patients, but not their physicians, cited fatalistic views about cancer as a barrier. Conversely, physicians identified competing priorities, such as psychosocial stressors or comorbid medical illness, as barriers to screening. In this culturally diverse group of patients seen at community health centers, similar barriers to screening were reported by patients of different backgrounds, but physicians perceived other factors as more important.</p> <p>Conclusion</p> <p>Further study of these barriers is warranted.</p

Decreasing Bias and Improving Education on Non-Invasive Colorectal Screening Methods

It is estimated that in 2020, nearly 148,000 Americans will be diagnosed with colorectal cancer and 53,200 Americans will die from colorectal cancer (Siegel et al., 2020). One- half of all cases and deaths are due to modifiable risk factors such as diet and smoking and it has been shown that early screening and detection can greatly decrease the morbidity and mortality of colorectal cancer yet colorectal cancer related deaths still ranks among the leading causes of cancer-related deaths in the United States and the world. Early detection of colorectal cancer is crucial to reducing mortality and although this is known, the incidence of colorectal cancer diagnoses continues to increase annually in some age groups. Providers must ensure that education is being provided to patients about colorectal cancer and the benefits of early colorectal screening and detection. There are many options available to patients to detect colorectal cancer and the healthcare team must be supportive of the modality chosen by the patient. This benchmark project’s goal is to educate patients and providers on the importance of colorectal screening and the many methods available to patients. It is also important to decrease bias among physicians against the non-invasive colorectal screening methods. The goal is not to discredit the gold standard of colorectal screening, colonoscopy, but instead to allow the provider and patient to make an informed decision on a more patient personalized and less-invasive modality if colonoscopy is first refused. This could result in more patients adhering to a colorectal screening regimen that otherwise would not because colonoscopy was the only method offered to them. It is important to note that although colonoscopy is the gold standard for colorectal screening, colonoscopy is only beneficial to the patient if it is completed