Surveillance Instructions and Knowledge Among African American Colorectal Cancer Survivors

New Journal of Oncology Practice Early Release articles have been made available
(for the period 26 Dec 2013 to 2 Jan 2014)

HEALTH CARE DELIVERY

Original Contribution

Surveillance Instructions and Knowledge Among African American Colorectal Cancer Survivors

Maria Pisu, et al.

Published 2 January 2014, 10.1200/JOP.2013.001203

• Copyright © 2014 by American Society of Clinical Oncology

Surveillance Instructions and Knowledge Among African American Colorectal Cancer Survivors

1. Maria Pisu, PhD⇑, 
2. Cheryl L. Holt, PhD, 
3. Aquila Brown-Galvan, MPH,
4. Temeika Fairley, PhD, 
5. Judith Lee Smith, PhD, 
6. Arica White, PhD, MPH,
7. Ingrid J. Hall, PhD, MPH, 
8. Robert A. Oster, PhD and 
9. Michelle Y. Martin, PhD

+Author Affiliations

1. University of Alabama at Birmingham, Birmingham, AL; University of Maryland, College Park, MD; and Centers for Disease Control and Prevention, Atlanta, GA

1. Corresponding author: Maria Pisu, PhD, MT 636, 1720 Second Ave South, Birmingham, AL 35294-4410; e-mail: mpisu@uab.edu.

Abstract

Introduction: African Americans are less likely than other racial/ethnic groups to receive appropriate surveillance, an important component of care to achieve better long-term outcomes and well-being after colorectal cancer (CRC) treatment. This study explored survivors’ understanding of surveillance instructions and purpose.

Patients and Methods: Interviews with 60 African American CRC survivors were recorded and transcribed. Compliance with surveillance guidelines was defined by disease stage and self-reported tests. Four coders (blind to compliance status) independently reviewed transcripts. Frequency of themes was reported by compliance status.

Results: Survivors (4 to 6 years postdiagnosis; women, 57%; age ≥ 65 years, 60%; rural location, 57%; early-stage disease, 62%) were 48% noncompliant. Most survivors reported receiving surveillance instructions from providers (compliant, 80%; noncompliant, 76%). There was variation in recommended frequency of procedures (eg, every 3 or 12 months) and in importance of surveillance stressed by physicians. Most survivors understood the need for follow-up (compliant, 87%; noncompliant, 79%). Lack of knowledge of/interest in surveillance was more common among noncompliant individuals (compliant, 32%; noncompliant, 52%).

Conclusion: Patients’ limited understanding about the importance of CRC surveillance and procedures may negatively affect compliance with recommendations in African American CRC survivors. Clear and enhanced communications about post-treatment recommendations in this population are warranted.