Investigating Hispanic/Latino perceptions about colorectal cancer screening: a community-based approach to effective message design.

OBJECTIVE: The Hispanic/Latino population has been documented as having the lowest colorectal cancer (CRC) screening rates in the United States, putting this group at-risk for late-stage presentation of disease. We assessed knowledge, attitudes, and behavior regarding CRC screening to inform the development of messages that promote screening among Hispanic/Latino patients.
METHODS: In-person structured interviews with Spanish-speaking adults age 50-80 at two clinics and a senior center in a Hispanic/Latino community (N=234).
RESULTS: Most (67.1%) participants had no more than an eighth-grade education and 63.3% reported their reading ability as less than "very good." Only 18.4% of participants correctly identified the colon on a diagram; 19.2% correctly described at least one aspect of a polyp. Less than half of the participants perceived themselves as at-risk for CRC, and less than one-third knew about any of the standard screening tests. After hearing descriptions of the screening tests, participants perceived stool cards as easier, safer, less painful, less embarrassing, and less scary than endoscopy (p<.001). Approximately two-thirds of unscreened patients said that screening had never been mentioned or suggested to them; about one-quarter said they did not get screened because they felt fine or were not worried. Over 96% of participants said they would get screened if a doctor suggested it.
CONCLUSION: Assessing knowledge, attitudes, beliefs, and experiences in the community of interest is a promising approach for developing effective targeted health messages. PRACTICE IMPLICATIONS: Messages to increase CRC screening knowledge and behavior in the Hispanic/Latino community should address risk factors, identify relevant anatomy, explain polyps and their asymptomatic presentation, and clearly describe options.