GENDER PREFERENCE OF ENDOSCOPIST AS A BARRIER TO COLORECTAL CANCER SCREENING IN INNER-CITY MINORITY POPULATION: 338
AMERICAN JOURNAL OF GASTROENTEROLOGY(2004)
Abstract
Purpose: Colorectal cancer is the 2nd leading cause of cancer-related deaths. Studies have shown that women and minority are less likely to undergo colorectal cancer screening. Gender preference for endoscopists has been suggested as a potential barrier. The purpose of our study is to assess whether gender preference for endoscopist serves as a barrier to colorectal cancer screening in inner-city minority population. Methods: We conducted a pilot study of 31 women and 22 men referred to the GI clinic for colon cancer screening in Newark, NJ. The patients were predominantly African American and Hispanic. At the time of initial consultation, a questionnaire was administered to the patients regarding their knowledge of colorectal cancer screening and whetherthey have genderpref-erence for endoscopist. For those patients that expressed gender preference, they were assigned an endoscopist of gender of their choice. Results: The mean age of women was 57.7 +/- 6.3 years and for men 58.7 +/- 6.5 years. Overall, 42% of total female and 27% of total male patients had gender preference for endoscopists, but this was not statistically significant. Of those that expressed preference, 92% of the women and 67% of the men preferred same sex endoscopist. All of the patients with gender preference would nevertheless proceed with colonoscopy even if they did not have the gender option. Younger patients (age <60) were more likely to have preference and this was statistically significant using univariate analysis. Compliance was not improved in those with preference. A disparity was seen in comparison to other cancer screening tests. Approximately 50% of patients were aware of colonoscopy. Only 13% of women and 27% of men were offered colonoscopy prior to our visit. This is in contrast to 90%, 97% and 77% had had their mammogram, PAP smear, and prostate cancer screening done respectively. Conclusions: Gender preference for endoscopist does not preclude inner-city minority patients from undergoing screening colonoscopy. The most striking barrier to screening in our study population is the lack of physician recommendation. In addition to increasing community awareness and education to colon cancer, more aggressive efforts must be made by all physicians to encourage colon cancer screening.
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Key words
colorectal cancer screening,endoscopist,colorectal cancer,gender preference,inner-city
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