COLORECTAL SCREENING PATTERNS AND PERCEPTIONS OF RISK AMONG AFRICAN-AMERICAN USERS OF A COMMUNITY-HEALTH CENTER

This study investigated risk perceptions and screening patterns for co lorectal cancer among predominately low-income African-Americans age 5 0 and older who used a community health center. The majority of respon dents either rated their risk as below average (36%) or did not know t heir risk (37%) for colorectal cancer. Individuals who provided a risk estimate versus those who did not know their risk were younger and he ld more accurate beliefs about colorectal cancer. Attributions of perc eived risk best distinguished respondents who evaluated their risk to be below average versus average and above average. Compared to respond ents who could not explain their risk, those who provided psychologica l, personal action, and heredity causes were more likely to view their risk as below average than average or above average. In comparison to national norms, these subjects reported higher frequencies of ever ha ving had a digital rectal exam (DRE, 90%), fecal occult blood test (FO BT, 75%) and sigmoidoscopy (SIG, 33%). Moreover, 63%, 53%, and 81% rep orted their most recent screening for DRE, FOBT, and SIG, respectively , in accordance with ACS and NCI recommended guidelines. However, a su bsequent medical audit failed to confirm these self-reports. These res ults suggest that: 1) educational efforts are needed to enhance knowle dge and accuracy of risk perceptions for colorectal cancer; 2) further studies on attributions of risk are needed that may prove useful for developing intervention programs, and 3) studies need to interpret sel f-report data for colorectal cancer with caution.