...needs to increase participation in colon cancer screening. The author used a convenience sample of 15 African-American women between the ages of 45-69 recruited from a moderately large church in a major urban city. Results of the study showed that there was a very low level of participation in colon cancer screening among the women in the group. Over 70 percent had a college degree or higher and 62 percent had no knowledge about colorectal cancer. 77 percent were employed with 69 percent having health insurance; 38 percent did not perceive themselves at any risk for colorectal cancer; and only 23 percent stated that they had been tested for colon cancer. Reasons for not getting screened were: fear; afraid of pain; doctor never recommended any tests; had no symptoms; competing health histories; embarrassment; and flaws in risk perception.

Key Words: African-American Women; Elderly African-American Women; Colorectal Cancer

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Colorectal cancer (CRC), the third most common cancer in African-American men and women, has mortality rates 20-30 percent higher than similar Caucasian populations. In 1999, 13 percent of African-American women were diagnosed with colorectal cancer; and, according to the American Cancer Society (2000), they also have the highest cancer mortality rate. Of 67,000 women diagnosed with colorectal cancer each year, more than 40 percent will die of the disease. Colorectal cancer strikes women nearly as often as men and frequently begins without symptoms (American Gastrological Association, 2001). According to the Harvard Report on Cancer Prevention (1999), screening rates are higher among whites due to increased access to health care and education. Lifestyle, diet and access to screening are important factors in cancer prevention. Low participation in cancer screening among African-Americans is a contributing factor in the delay for seeking medical care. Although colon cancer is sporadic, at least 15 percent of cases have an inherited component. There are two types of inherited colon cancer: 1) familial adenomatous polyposis; and 2) hereditary nonpolyposis colorectal cancer (Glaser, 1998).

Although men and women of any age may be diagnosed with colorectal cancer, more than 9 in 10 cases are people at the age of 50 or older (Colon Cancer Alliance, 2000). The American Cancer Society (ACS) recommends three screening tests for the detection of colorectal cancer: digital rectal exam, fecal occult blood tests, and sigmoidoscopy. Sarna and Chang (2000), reported in their study that only 36% of their subjects had been screened with fecal occult blood test and sigmoidoscopy, 21% had never participated in stool testing and 47% had never undergone sigmoidoscopy. There is increasing consensus that screening for colorectal cancer may reduce mortality, yet screening rates are far too low to achieve the public health goal of reducing mortality for colorectal cancer (Wing, P.A. et al., 1995). This suggests that a better knowledge about the factors that encourage compliance to screening for CRC is needed for African-American women. The colon cancer screening recommendation has been made for more than a decade, with current studies suggesting insufficient public awareness and under-utilization of colorectal screening in the U.S.

Based on the review of the literature, part of every individual's perception of health and illness is influenced by knowledge, beliefs and cultural orientation. This study was based on the "Health Belief Model" by Becker and others (1974), which explains why people do not...

NOTE: All illustrations and photos have been removed from this article.



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