A0163 - A Cross-Sectional Quality Improvement Study: Assessing the General Public Knowledge of Colorectal Cancer (CRC) by Comparing Races During CRC Awareness Month in March 2022 at a Safety Net Hospital
Jose Russe-Russe, MD, Kristen Farraj, DO, James Pellegrini, MD, Rezwan Munshi, MD, Paul Mustacchia, MD, MBA Nassau University Medical Center, East Meadow, NY
Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death and the third most common cause of cancer amongst men and women in the US. Despite being a preventable malignancy, about 7 in 10 US adults are up-to-date with CRC screening. It is predicted that by 2035 there will be a 27.8% increase in mortality secondary to colorectal cancer. In recent years, only approximately half of the Hispanic population in the US has reported obtaining CRC screening, yet by 2050 30% of the US, people will be Hispanic.
Methods: A short survey about CRC awareness, provided by the Centers for Disease Control and Prevention (CDC), was randomly handed out to patients, employees, and visitors at Nassau University Medical Center, a 530-bed safety-net hospital in Long Island, NY. The surveys were randomly distributed during National Colorectal Cancer Awareness Month (NCCAM). Statistical analysis was conducted to ascertain the overall percentage of accurate responses and compare Hispanic (H) and non-Hispanic (n-H) responses.
Results: 278 individuals (72 H, 206 n-H) completed the CRC awareness survey during NCCAM. Our findings reflect an overall good understanding regarding symptomatology (80.6% [66.6% H; 85.4% n-H]), gender disease (93.5% [90.3% H; 94.7 n-H]), preventive screening (89.2% [95.8% H; 86.9% n-H]), and symptom-related CRC (87.8% [77.7% H; 91.3% n-H]) (Table 1). We also saw a significant shortfall regarding screening alternatives (45.3% [12.5% H; 56,8% n-H]) and age-starting (24.1% [12.5% H; 28.1% n-H]) and age-ending screenings (22.3% [11.1% H; 26.2% n-H]) (Figure 1).
Discussion: Since the mid-1980s, the overall CRC incidence has declined steadily due to increased general awareness, uptake of screening, and modifying risk factors. However, the high incidence and mortality rates in the US could be due to a lack of CRC knowledge. Our study provides evidence of CRC awareness deficiency. This disparity among races was highly noticeable, with only 12% of Hispanics compared to 56% of non- Hispanics aware of other screening modalities. Poor socioeconomic status, low education levels, and language barriers could be contributing factors. Interestingly, both groups showed a decreased awareness of the appropriate age to begin colorectal cancer screening. In light of our findings, and with the rapid rise in the Hispanic population throughout the US, further action is warranted to increase awareness of CRC, particularly amongst this vulnerable population, ultimately saving lives.
Figure: Figure 1: The percentage of accurate responses to the CRC Awareness Survey among Hispanics and Non-Hispanics patients, employees, and visitors of a large New York safety-net hospital during National Colorectal Cancer Awareness Month.
Legend:
Q: Question
A: Correct answer
Total Answers
(n=278)
%
Correct Answers
Hispanics
(n=72)
%
Correct Answers
Non-Hispanics
(n=206)
%
Q1: Who gets colorectal cancer?
: Men only.
: Women only.
A: Both men and women.
13/278
5/278
260/278
4.7
1.8
93.5
65/72
90.3
195/206
94.7
Q2: Colorectal cancer is the second leading cancer killer in the U.S.
A: True.
: False.
170/278
107/278
61.2
38.5
45/72
62.5
125/206
60.7
Q3: Getting screened for colorectal cancer can help you prevent the disease.
A: True.
: False.
248/278
22/278
89.2
7.9
69/72
95.8
179/206
86.9
Q4: If you don’t have any symptoms, it means you don’t have colorectal cancer.
: True.
A: False.
36/278
244/278
12.9
87.8
56/72
77.7
188/206
91.3
Q5: Screening is recommended to begin at what age?
: 40.
A: 45.
: 50.
: 60.
122/278
67/278
84/278
6/278
43.9
24.1
30.2
2.2
9/72
12.5
58/206
28.1
Q6: At what age can you stop getting screened for colorectal cancer?
: 60.
: 65.
: 70.
A: 75.
: 80.
15/278
10/278
29/278
62/278
160/278
5.4
3.6
10.4
22.3
57.6
8/72
11.1
54/206
26.2
Q7: The only screening test for colorectal cancer is colonoscopy.
: True.
A: False.
152/278
126/278
54.7
45.3
9/72
12.5
117/206
56.8
Q8: Which of these are symptoms of colorectal cancer?
: Blood in or on your stool (bowel movement).
: Stomach pain, aches, or cramps that don’t go away.
: Losing weight and you don’t know why.
A: All of these.
: None of these.
34/278
10/278
4/278
224/278
11/278
12.2
3.6
1.4
80.6
4.0
48/72
66.6
176/206
85.4
Table: Table 1: CRC Awareness Survey provided by the CDC given on random dates to Hispanics and non-Hispanics patients, employees, and visitors of a large New York safety-net hospital during National Colorectal Cancer Awareness Month. *For an estimated population of 1,000 on any given day in a large safety-net hospital, 278 participants account for a 95% confidence level (p<0.05).
Disclosures:
Jose Russe-Russe indicated no relevant financial relationships.
Kristen Farraj indicated no relevant financial relationships.
James Pellegrini indicated no relevant financial relationships.
Rezwan Munshi indicated no relevant financial relationships.
Paul Mustacchia indicated no relevant financial relationships.
Jose Russe-Russe, MD, Kristen Farraj, DO, James Pellegrini, MD, Rezwan Munshi, MD, Paul Mustacchia, MD, MBA. A0163 - A Cross-Sectional Quality Improvement Study: Assessing the General Public Knowledge of Colorectal Cancer (CRC) by Comparing Races During CRC Awareness Month in March 2022 at a Safety Net Hospital, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.
