Perceived barriers and benefits to colon cancer screening among African Americans in North Carolina: how does perception relate to screening behavior?

This study investigated perceived barriers and benefits, as conceptualized by the Health Belief Model,in relation to screening for colorectal cancer (CRC) among African-American adults participating in a church-based health promotion program. CRC is one of the most common cancers and is the second leading cause of cancer death for men and women. Screening can be effective at detecting cancer at treatable stages, but a large proportion of people at risk have not been screened or are not screened regularly, as recommended by national guidelines. In this study, logistic regression was used to assess the relation of barriers and benefits to self-reported history of fecal occult blood testing (FOBT), flexible sigmoidoscopy, and colonoscopy. Barriers were significantly negatively related to recent FOBT and recent sigmoidoscopy. Benefits were significantly related to having a recent sigmoidoscopy and a recent colonoscopy but not to recent FOBT. Results suggest that the way people perceive sigmoidoscopy and colonoscopy may differ from FOBT with respect to the relative importance of perceived benefits versus barriers. Findings are discussed within the context of these Health Belief Model constructs and implications for health promotion programming.