Efuni Elizaveta, DuHamel Katherine N, Winkel Gary, Starr Tatiana, Jandorf Lina
Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, USA.
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, New York, NY, USA.
Psychooncology. 2015 Sep;24(9):1138-44. doi: 10.1002/pon.3733. Epub 2014 Dec 19.
Colorectal cancer (CRC) screening continues to be underused, particularly by Latinos. CRC and colonoscopy fear, worry, and fatalism have been identified as screening barriers in Latinos. The study purpose was to examine the relationship of optimism, fatalism, worry, and fear in the context of Latinos referred for CRC screening.
Our sample included 251 Latinos between the ages of 50 and 83 years who had no personal or immediate family history of CRC, no personal history of gastrointestinal disorder, no colonoscopy in the past 5 years, and received a referral for a colonoscopy. Face-to-face interviews were performed, and data were analyzed using regression models.
Greater optimism (β = -1.72, p < 0.000), lower fatalism (β = 0.29, p < 0.01), and absence of family history of cancer (β = 1, p < 0.01) were associated with decreased worry about the colonoscopy. Being female (β = 0.85, p < 0.05) and born in the USA (β = 1.1, p < 0.01) were associated with greater worry about colonoscopy and the possibility of having CRC. Family history of cancer (β = 2.6, p < 0.01), female gender (β = 2.9, p < 0.000), not following the doctor's advice (β = 2.7, p < 0.01), and putting off medical problems (β = 1.9, p < 0.05) were associated with greater fear. In the multiple regression model, lower optimism (β = -0.09, p < 0.05), higher fatalism (β = 0.28, p < 0.01), and female gender (β = 0.9, p < 0.05) were associated with greater worry.
Interventions that address fatalism and promote optimistic beliefs may reduce worry among Latinos referred for colonoscopy. Interventions that alleviate colonoscopy fear because of family history of cancer particularly among Latino women may help improve distress about CRC screening.
结直肠癌（CRC）筛查的使用率仍然较低，尤其是在拉丁裔人群中。CRC和结肠镜检查的恐惧、担忧及宿命论已被确定为拉丁裔人群进行筛查的障碍。本研究的目的是在接受CRC筛查转诊的拉丁裔人群背景下，探讨乐观主义、宿命论、担忧和恐惧之间的关系。
我们的样本包括251名年龄在50至83岁之间的拉丁裔人群，他们没有CRC的个人或直系家族病史，没有胃肠道疾病的个人病史，在过去5年内未进行过结肠镜检查，并收到了结肠镜检查的转诊。进行了面对面访谈，并使用回归模型对数据进行了分析。
更高的乐观主义（β = -1.72，p < 0.000）、更低的宿命论（β = 0.29，p < 0.01）以及没有癌症家族史（β = 1，p < 0.01）与对结肠镜检查的担忧减少相关。女性（β = 0.85，p < 0.05）和在美国出生（β = 1.1，p < 0.01）与对结肠镜检查以及患CRC可能性的更大担忧相关。癌症家族史（β = 2.6，p < 0.01）、女性性别（β = 2.9，p < 0.000）、不听从医生建议（β = 2.7，p < 0.01）以及拖延医疗问题（β = 1.9，p < 0.05）与更大的恐惧相关。在多元回归模型中，更低的乐观主义（β = -0.09，p < 0.05）、更高的宿命论（β = 0.28，p < 0.01）以及女性性别（β = 0.9，p < 0.05）与更大的担忧相关。
解决宿命论并促进乐观信念的干预措施可能会减少接受结肠镜检查转诊的拉丁裔人群的担忧。减轻因癌症家族史尤其是拉丁裔女性对结肠镜检查的恐惧的干预措施，可能有助于改善对CRC筛查的困扰。
