These and other in-depth methodological probes would serve to improve both the CSQ as a research instrument via modifications and thereby improve our understanding of individuals' willingness to participate in cancer screenings as a result of either additional questions developed or modifications to existing questions currently used in the CSQ. The burden of cancer falls disproportionately on the poor and disadvantaged in society, but the reasons for these disproportionate cancer-related health disparities are still unclear.
Both English and Spanish versions of the CSQ were available and used at the preference of the interviewee. Unadjusted bivariable analysis was used as a pathway leading to adjusted multivariable analyses. The unadjusted bivariable findings from Question 17a-j are shown in Fig 2. Are you … read response choices above?
The overall aim of the 3-City Cancer Screening Study was to address and understand a range of issues related to factors that determine whether blacks and Puerto Rican Hispanics, compared with non-Hispanics whites, would be willing to take part in cancer screening examinations. Copyright notice.
Nevertheless, future methodological studies could probe for a clearer understanding of the beliefs of the respondents when they answered questions about willingness to participate in different types of cancer screenings. Studies conducted with different minority groups have found that in addition to the barriers already mentioned, other important factors hinder cancer screening utilization for these populations.
The publisher's final edited version of this article is available free at Cancer Control. Multivariable logistic regression analyses revealed that blacks and Puerto Ricans were often more likely OR 2. Abstract Background In the United States, blacks and Hispanics have lower cancer screening rates than whites have.
Try out PMC Labs and tell us what you think. The findings from this study show that blacks and Hispanics self-report a willingness to participate in cancer screenings that is at least equal to that of whites, and they are frequently more willing than whites, under several different circumstances.
Cookies in use
Finally, the fit of the logistic regression was assessed by the omnibus test, the Hosmer-Lemeshow Test, as well as the classification table and the residual scores. Haghpanah, and Ms Anne X. Truong, three graduate students, for their assistance with preliminary analyses related to this manuscript.
Further in this exploratory first use of the CSQ in a survey, as none of the nonstatistically ificant findings showed any noteworthy differences, they were not judged to be meaningful. The findings from this study provide evidence that blacks and Hispanics self-report that they are either as willing or more willing than whites to participate in cancer screening programs.
Encouraging the willingness of minorities to take part in screening programs would equalize participation rates in screening and thus improve outcomes as regards to cancer mortality. The level of education and level of income variables were collected via an ordinal listing of nine ascending of educational level and of 10 ascending of income level, each of which was then collapsed into three ascending for the demographic table and five ascending for the multivariable analyses.
Whites were consistently the least likely to indicate willingness to participate, and Puerto Rican Hispanics were consistently the most willing. There were three exceptions in which a minority group was less likely to self-report willingness to participate than whites. Table 1 shows the key questions from the CSQ that constituted the primary dependent variables, ie, willingness to participate in cancer screenings.
These factors include cultural differences, racial bias, emotions and beliefs, 4647 fear of cancer, embarrassment, acculturation, 4849 and fatalistic beliefs. Learn More.
The only exceptions were colon cancer screenings for which blacks were the most willing and skin cancer screenings with blacks appropriately seeing themselves at lowest risk and thus least willing. Except for this finding on skin cancer in blacks, and blacks nor Maryland Rican Hispanics self-reported a lower willingness than whites for any dating of the site-specific types of cancer.
The CSQ addresses a range of issues related to the willingness of minorities to participate in cancer screening examinations, with a focus on whether minorities are more reluctant to participate in cancer screening examinations and, if so, the reasons for their reluctance. This study presents the self-reported willingness by blacks, Puerto Rican Hispanics, and non-Hispanic whites to participate in cancer screenings in black cancer screening situations. A recent article focusing on the comparative willingness to participate in cancer screenings between Puerto Ricans living in San Juan, Puerto Rico, and Puerto Rican Americans living in New York, NY, reported that 1 those living in San Juan had a slightly but consistently higher self-reported willingness to participate in cancer screenings than those living in New York, and rican the odds of San Juan Puerto Ricans participating in skin cancer screening, compared with New York Puerto Ricans were 3-fold higher in regard to participation in skin cancer screenings.
The current wording of questions related to cancer screening participation as used in the CSQ reflects how invitations to have screenings for a specific type of cancer are typically announced in a community or referred to by physicians, and thus they likely have face validity, as was demonstrated in our pilot study phase. Several recent surveys have asked respondents about their past cancer screening activities and participation.
Two involved blacks and skin cancer circumstances for skin cancer screening, and having a skin biopsy and one involved Puerto Rican Hispanics having a alcohol habit interview. Respondents who indicated that they are Hispanic further specified whether they are Puerto Rican or Mexican-American, or Other Hispanic. Given that the overall aim of the 3-City Cancer Screening Study was to address a range of issues related to factors that determine whether blacks and Puerto Rican Hispanics, compared with non-Hispanics whites, would be willing to take part in cancer screening examinations, there is clear justification for presenting both the unadjusted bivariable analyses and the adjusted multivariable analyses since each has specific utility to different audiences.
In the United States, blacks and Hispanics have lower cancer screening rates than whites have. National Center for Biotechnology InformationU. Cancer Control. Author manuscript; available in PMC Jun Ralph V. KressinPhD, B. Author information Copyright and information Disclaimer. Black females, for example, have the highest incidence rates for colorectal cancer White females have the highest incidence for breast cancer Puerto Rican Hispanic males, living in either Puerto Rico or the United States, also have high incidence and mortality rates for prostate, colorectal, and lung and bronchus cancers.
How likely are you to agree to have a cancer screening exam at the present time? The CSQ was derived from the ly deed questionnaire, the Tuskegee Legacy Project TLP Questionnaire,which was deed to explore whether minorities are more reluctant than whites to participate in biomedical research, and if so, to explore the reasons including the Tuskegee Syphilis Study for any observed differences.
This understanding is critical to achieving early cancer detection goals in order to reduce the higher cancer mortality currently observed in minority populations.
Studies on the screening behaviors of minorities are increasing, but few focus on the factors that contribute to this discrepancy. The telephone survey followed a attempt dialing protocol, in which up to 10 attempts were made unless a final disposition was obtained. For example, overall cancer incidence and mortality rates are higher for blacks compared with other groups. A final disposition was attained when 1 the respondent completed the interview, 2 the telephone was found to be invalid, 3 the record reached 10 attempts distributed among three different day parts, or 4 the respondent gave a final refusal.
The TLP Questionnaire was developed over a period of 3 years via focus group studies and a series of pilot studies and is described elsewhere.
Was it a general concern about that type of cancer, or were they well enough informed to envision different specific cancer screening procedures as used by physicians eg, FOBT vs colonoscopy for colon cancer? A check of the magnitude of the regression coefficients in these analyses revealed a good fit of the logistic regression model as used. Conclusions The findings from this study provide evidence that blacks and Hispanics self-report that they are either as willing or more willing than whites to participate in cancer screening programs. ORs ranged from 1.
Puerto Rican Hispanics were the most willing to indicate that they would participate; whites were the least willing. However, although there is consensus that early detection of cancer is one of the most effective means of assuring timely treatment and survival, too few people take advantage of the tests available to screen early for common cancers.
Experienced, supervised personnel conducted the interviews using CATI software Computers for Marketing Corp, San Francisco, California The CSQ study provided for a disproportionally allocated, stratified, random digit sample of telephone-equipped residential households in the targeted sites. Given these findings, efforts by researchers, medical personnel, and community health workers are needed to overcome the often-cited barriers faced by these minority populations.
While the burden of cancer in minority populations is high, attempts to provide cancer screening examinations to minority populations have met with varied success at best. Address correspondence to Ralph V.
E-mail: ude. The mean age of respondents was Percentage likely to participate in cancer screenings dependent on type of cancer being screened for in the 3-City Cancer Screening Study. The only exception involved blacks and skin cancer, where the odds of willingness to participate in cancer screenings were,appropriately and understandably, half that of whites. The survey sample was drawn from the total noninstitutionalized adult populations ages 18 years and over residing in telephone-equipped dwelling units in the three target cities.
See other articles in PMC that cite the published article. Question 7 is the single best gestalt item in the CSQ to assess overall willingness to participate without regard to specific type of cancer, while the subsections of Question 16 ask about willingness to participate in 10 site-specific types of cancer screenings.
An international opinion research corporation Macro International, Inc, Burlington,Vermont conducted the random-digit-dial survey using a computer-assisted telephone interviewing CATI system.
According to the National Cancer Institute in1 the cancer incidence rate of blacks in the United States was Differences by gender have also been observed. Cancer is the second-leading cause of death in the United States and affects people of all racial and ethnic groups. Clearly, the high end for both practices and intentions were found for those cancer screening programs that have received major attention in the media and have the biggest campaigns for participation, such as breast and cervical cancers in women.
However, the rates of cancer occurrence and cancer death vary ificantly between ethnic groups. Introduction Cancer is the second-leading cause of death in the United States and affects people of all racial and ethnic groups.
A limitation of this study was that it was the first administration of the CSQ in a full survey, and therefore methodological questions remain to be answered about the CSQ as a research instrument.