A colorectal cancer prevention, screening, and evaluation program in community black churches.

Colorectal cancer incidence and related mortality are significantly higher in blacks than in whites. The black church has been identified as a means of promoting health issues and intervention programs. The purpose of this study was to implement and evaluate a colorectal cancer prevention and screening program in community black churches. A total of 1,488 Coloscreen III kits were distributed, and a telephone survey was conducted to examine the demographic profile, attitudes, and behaviors of those who returned the kit (17.5 percent) compared with those who did not (82.5 percent). The survey revealed that the majority of both returners and nonreturners felt that the test could detect bowel cancer and that early detection could result in cure. The returners were significantly older and less likely to smoke. The low response was attributed primarily to the test's dietary requirements. Both groups reportedly made changes in their lifestyles as a result of the educational component of the program--that is, they increased their fiber intake and decreased their fat intake, alcohol consumption, and smoking. Even with the low response of this study, educational benefits were evident. If colorectal cancer screening programs in community black churches are to be effective, however, diet-related issues must be addressed.