ASPO Abstracts
Masculinity Barriers to Colorectal Cancer Screening Completion among American Indian/Alaska Native, Black, and White men (ages 45 - 75)
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Background. Colorectal cancer (CRC) mortality is largely preventable and treatable with early detection screening, yet significant racial disparities remain for non-Hispanic Black and American Indian/Alaska Native (AIAN) men. Research is necessary to elucidate the factors leading to disparate CRC screening rates and inequitable healthcare utilization among Black and AIAN men. We aimed to determine if masculinity barriers to medical care influence CRC screening completion among Black and AIAN men compared to Non-Hispanic White men (ages 45 - 75).Methods. A population-based survey study was employed online between December 2020 and January 2021. Participants self-reported CRC screening history and completed our previously validated Masculinity Barriers to Medical Care (MBMC), Psychosocial Factors, and CRC Screening survey. Logistic regression models were fit to each of the four MBMC subscales predicting ever having had CRC screening. The odds of reporting CRC screening were compared to 4 subscales from the MBMC and were adjusted for marital status, education, insurance status, having a regular provider, and having a family history of CRC. Results. The cohort (N=435) consisted of 136 AIAN, 99 Black, and 200 White men, of which 49% were age 45-59 and 51% age 60-75. Overall, 68% reported previous CRC screening, with the older cohort having a >3-fold increased odds of screening. For all men combined, a unit increase in the Being Strong subscale was associated with a 54% decreased odds of CRC screening (OR 0.46, 95% CI 0.23 to 0.94; P=.034), while a unit increase in Negative Attitudes Towards Medical Professionals and Exams decreased the odds of screening by 57% (OR 0.43, 95% CI 0.21 to 0.86; P=.018). There was also evidence of an effect modification by race with Black men scoring higher on the Negativity Towards Medical Professionals and Exams having decreased odds of screening. Conclusions. Constructs of masculinity play an important role in determining men's participation in CRC screening. Additional study is needed to understand how masculinity barriers might be overcome to motivate CRC screening completion.
Keywords: Colonic Neoplasms; Early Detection of Cancer; Minority Health; Indigenous Peoples; Men's Health