Colorectal cancer attitudes vary by ethnicity

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Men and people of South Asian descent are more likely to have unfavorable perceptions of colon cancer screening, research from the UK shows.

The findings point the way toward strategies to get more people screened, Dr. Taina Taskila of the University of Birmingham, a researcher on the study, told Reuters Health.

For any type of cancer, she noted, it can be difficult to encourage people to get screened and increase awareness of potential symptoms. “It’s one of the most feared of all illnesses and people ... don’t want to know about it if they don’t have to,” she said.

Survival from colorectal cancer is much more likely if the disease is detected early, but most cases are found relatively late, Taskila and her colleagues note in the British Journal of Cancer.

The UK launched a national program in 2006 to screen all men and women 60 to 69 years old with a fecal occult blood test (FOBT), in which the stool is tested for blood. But studies looking at “uptake” of screening have found fewer than 60 percent of eligible people are getting tested.

Attitudes toward colorectal cancer screening are a key determinant in whether a person actually gets the test, the researchers add. To better understand why people might be reluctant to undergo screening, they surveyed 11,355 people about their attitudes toward both FOBT and colonoscopy, as well as whether they had symptoms that could indicate colorectal cancer.

While other researches have investigated attitudes toward screening, Taskila noted in an interview, this study is the first to look at whether having symptoms influences these attitudes.

Overall, the researchers found, 14 percent of the people surveyed had a negative perception of colorectal cancer screening in general, with 13 percent saying they felt FOBT was “very unacceptable” or “unacceptable,” and 55 percent saying the same of colonoscopy.

Negative attitudes were more common among men, older people, and people of South Asian heritage.

However, people who reported certain potential symptoms of colorectal cancer (tiredness, belly pain, bleeding from the anus, or “pain, soreness, discomfort, itching, or lumps” around the anus) had more favorable attitudes toward screening.

People who had at least three such symptoms were also more likely to have a favorable attitude toward screening than those who reported fewer, while people from a Black Caribbean background had more favorable attitudes than other ethnic groups.

Based on the findings, Taskila and her team say, “culturally relevant screening strategies should be developed” to help make colorectal cancer screening more acceptable to ethnic minorities, and to increase awareness of signs and symptoms of the disease.

SOURCE: British Journal of Cancer, July 2009.

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