ASPO Abstracts
Barriers to Cancer Screening among Southwest American Indian Men Living on a Reservation
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose of the study: Screening rates among American Indian (AI) men remain low without programs
specifically designed for men. Community surveys were conducted between 2018 and 2019 among AI
men to understand colorectal and prostate cancer screening behavior and identify barriers to screening.
Methods: The study was implemented using community based participatory research principles with the
Hopi Tribe. The surveys were conducted by a male Hopi Native Patient Navigator using an audience
response system with small groups of men, 50 years of age or older who live on the Hopi Reservation.
Logistic regression analysis was performed to identify factors associated with having cancer screening.
Results: A total of 83 eligible men completed the surveys. Colorectal cancer screening rate (having had
fecal occult blood test or colonoscopy) increased from 51% in 2012 to 71% in 2018. Prostate cancer
screening rate (having had prostate specific antigen test or digital rectal exam) did not change (35% in
2012 and 37% in 2018). Among men who had screening, 51% had colorectal cancer screening and 55%
had prostate cancer screening within past 3 years. Thirty-four percent of men responded that they learned
about cancer screening from HOPI Cancer Support Services. Only 13% learned about cancer screening
from health care providers. Only 33% of men reported that they looked for medical information using
electronic devices in the past year. Past prostate cancer screening was significantly associated with
having colorectal cancer screening (OR 5.33, 95% CI: 1.38-20.59). Past colorectal cancer screening was
significantly associated with having prostate cancer screening (OR 5.37, 95% CI: 1.36-21.17).
Conclusion: Lack of knowledge on cancer screening may be one of the major barriers to cancer screening
causing screening rates to remain low. There is a desire by Hopi men to have community education
interventions and support from a Hopi Native Patient Navigator to help them access screening.
Keywords: American Indians, Cancer Screening, Men’s Health, Patient Navigation