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Am J Health Promot. 2012 May-Jun;26(5):295-300. doi: 10.4278/ajhp.110113-QUAN-20.

Unwillingness to participate in colorectal cancer screening: examining fears, attitudes, and medical mistrust in an ethnically diverse sample of adults 50 years and older.

Author information

  • 1Moffitt Cancer Center, Tampa, Florida 33612-9416, USA. Shalanda.Bynum@moffitt.org

Abstract

PURPOSE:

Identify the influence of medical mistrust, fears, attitudes, and sociodemographic characteristics on unwillingness to participate in colorectal cancer (CRC) screening.

DESIGN:

Cross-sectional, disproportionally allocated, stratified, random-digit-dial telephone questionnaire of noninstitutionalized households.

SETTING:

New York City, New York; Baltimore, Maryland; San Juan, Puerto Rico.

SUBJECTS:

Ethnically diverse sample of 454 adults ≥50 years of age.

MEASURES:

Health status, cancer screening effectiveness, psychosocial factors (e.g., perceptions of pain, fear, trust), and CRC screening intentions using the Cancer Screening Questionnaire, which addresses a range of issues related to willingness of minorities to participate in cancer screening.

ANALYSIS:

Multivariate logistic regression was used to model the probability of reporting unwillingness to participate in CRC screening.

RESULTS:

Fear of embarrassment during screening (odds ratio [OR] = 10.72; 95% confidence interval [CI], 2.15-53.39), fear of getting AIDS (OR = 8.75; 95% CI, 2.48-30.86), fear that exam might be painful (OR = 3.43; 95% CI, 1.03-11.35), and older age (OR = 1.10; 95% CI, 1.04-1.17) were positively associated with unwillingness to participate in CRC screening. Fear of developing cancer (OR = .12; 95% CI, .03-.57) and medical mistrust (OR = .19; 95% CI, .06-.60) were negatively associated with unwillingness to screen.

CONCLUSIONS:

Findings suggest that CRC health initiatives should focus on increasing knowledge, addressing fears and mistrust, and normalizing CRC screening as a beneficial preventive practice, and should increase focus on older adults.

PMID:
22548424
[PubMed - indexed for MEDLINE]
PMCID:
PMC3807238
Free PMC Article
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