R. L. Hoffman1, K. O’Neill2, K. Collier1, C. B. Aarons1, M. K. Lee1, R. R. Kelz1 1University Of Pennsylvania,Philadelphia, PA, USA 2Yale University School Of Medicine,New Haven, CT, USA
Introduction: Outreach programs aimed at reducing disparities in cancer care need to consider the cultural nuances of each community in order to be effective and sustainable. The aim of this study was to gain insight into the beliefs of the local community regarding colon cancer screening and treatment.
Methods: In partnership with a large urban university cancer center, medical students and surgical residents and faculty participated in two community health outreach events focused on cancer prevention, screening and treatment in the surrounding community. Prior to the main educational event, an 11- item survey that addressed commonly held cancer myths and colon cancer knowledge was distributed to all participants. Myth items were adapted from the National Cancer Institute’s ‘Common Cancer Myths and Misconceptions’ website. The survey also collected demographic information and assessed participant willingness to undergo cancer screening (colonoscopy). Myth items were scored on a 5-point Likert scale from ‘strongly agree to strongly disagree,’ and knowledge items were scored as true/false or ‘I don’t know.’ Descriptive statistics and univariate analyses were performed.
Results: There were a total of 256 participants and 188 completed a survey (71% response rate). Attendees were predominantly insured (93%), female (80%) and African American (96%), with a mean age of 61 years (14.0; range 12-95 years). Seven percent of participants were unwilling to undergo a screening colonoscopy; 3% of those age ≤60 years compared to 9% >60 years. Of those unwilling to get a colonoscopy, 33% were male, 92% Black. Of the myths, 25% felt that surgery could cause cancer to spread. Patients ≤60 years old were more likely to believe that surgery could cause cancer spread (64% vs. 35% ≤60yrs; p=0.004). 25% endorsed mistrust in physicians (43% of those ≤60 years, 26% for those >60 years (p=0.03). 18% felt that cancer treatment was worse than the disease. Belief in these myths did not differ by gender. 74% of participants agreed that there were some measures people could take to prevent cancer. 48% were aware of the causes of colon cancer, 49% and 46% misunderstood or didn’t know the definitions of malignant and metastatic, respectively. Males were more unsure of these definitions than females (61% vs 55%, p=0.5 and 70% vs 55%; p=.01).
Conclusion: In the surrounding, predominantly African American community, knowledge of and willingness to undergo cancer prevention strategies was high. However, in participants ≤60 years, in which early detection of cancers is most beneficial, physician mistrust and belief in the surgical spread of cancer was also high. Particularly for cancers where surgery is the mainstay of treatment, surgeon participation in community outreach events is essential in order to minimize barriers to treatment, increase cancer-related knowledge and address disparities in care.