Rogers, Charles Ray (2013-12). Colorectal Cancer Screening and Young African-American Men: Male Role Norms, Knowledge, Attitudes, and Perceptions. Doctoral Dissertation. Thesis uri icon


  • Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer to kill African Americans in the U.S. Compared to White men, African-American men have CRC incidence and mortality rates 20% and 45% higher, respectively. Owing to CRC's high incidence and younger age at presentation among African-American men, CRC screening (CRCS) is warranted at age 45 rather than 50. Yet, most studies have focused on men older than 45. The findings of these studies suggest that CRC survival is inversely related to early detection, and advocate the continued need for development, testing, and translating prevention interventions into increase screening behavior. Hence, the two-fold purpose of this study was to (1) conduct a systematic review of the professional literature to assess African-American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assess the knowledge, attitudes, male role norms, perceptions of subjective norms, and perceptions of barriers associated with CRCS among young adult African-American men (ages 19-45) employing survey research methodology. Utilizing Garrard's Matrix Method, the systematic literature review synthesized 28 studies examining African-American men's knowledge, beliefs, and behaviors regarding CRCS. Six factors emerged as associated with CRCS intentions and behaviors: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. In addition, the mean methodological quality score of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. The second component of this study -- an on-line survey questionnaire -- described the male role norms, knowledge, attitudes, perceived subjective norms, and perceived barriers associated with screening for CRC among a non-random sample of 157 young adult African-American men. Ultimately, family history of cancer, work status, and perceived barriers were the critical factors associated with attitudes in all of our models/analyses. Of these, perceived barriers are the only factors amenable to change through health education efforts. Because this study was narrowly-focused on a specific group of African Americans, it provides a solid basis for developing structured health education interventions to increase young adult African-American men's intention to screen for CRC.

publication date

  • December 2013