Screening for Colorectal Cancer and Prevention in Ethnic Minorities (SCCOPEM): The Haitian Immigrant Community

Fritz Francois MD, Edmund Bini MD, David Diehl MD, Francesca Gany MD, MS, Chau Trinh-Shevrin DrPH, Danielle Greene MPH, Rachel Andre, Greta Elysée

Summary: Colorectal cancer is the third leading cause of cancer related deaths in the United States. Yet, if detected early, there is a 90% 5-year survival rate. Colorectal cancer is preventable with timely screening strategies, such as fecal occult blood testing and colonoscopy. Yet, New York State statistics revealed that only 43% of colorectal cancers were detected at an early stage in men, and only 39.2% of colorectal cancers were detected in early stages in women. On average, Blacks are diagnosed with colorectal cancer at later stages than are Caucasians. The Haitian immigrant community is growing in the United States, especially in New York. For Haitians, access to cancer care may be impeded by financial issues and cultural barriers. Cancer data on African-Americans are used as a surrogate for missing information on the Haitian community and in establishing cancer control priorities. The determination of Haitian community-specific colorectal cancer prevention barriers and strategies will: (1) enable greater informed acceptance of colorectal cancer screening; (2) facilitate the development and implementation of Haitian community-based colorectal cancer screening programs; and (3) provide an important foundation for future large-scale colorectal screening studies in the Haitian community.

Hypothesis: We hypothesize that surmountable barriers exist in the Haitian community that may significantly impact the acceptance of colorectal cancer screening.

Specific Aims: (1) To explore knowledge about colorectal cancer, including its risk factors and prevention, in the Haitian community; (2) To determine awareness of colorectal screening recommendations, and to explore attitudes towards, and willingness to use, various screening modalities to detect colorectal precancerous lesions and cancer in the Haitian community; (3) To determine effective cancer information dissemination modalities in the Haitian community; and (4) To develop the foundation for a long-term colorectal cancer screening and early detection referral and research program.

Methodology: SCCOPEM will use a combination of focus group and survey methodology to elucidate the Haitian community’s knowledge, beliefs, and attitudes about colorectal cancer screening, prevention, and cure. There will be two phases to SCCOPEM. Phase I will qualitatively examine the attitudes, barriers, and concerns regarding colorectal cancer and its screening within the Haitian community, while Phase II will use survey methodology, developed from the results of Phase I, to determine community colorectal cancer information, needs and facilitators of screening.