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New Mexico State University

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NMSU Program Expands Hispanic Colorectal Cancer Screening

LAS CRUCES - A New Mexico State University study suggests that promotoras - neighborhood level Spanish-speaking lay health workers or promoters - can significantly boost colorectal cancer screening participation among older, low-income Hispanics.

Ann Bock, a human nutrition professor at New Mexico State University, found that promotoras, Spanish-speaking lay health workers from the neighborhood, can sharply increase colorectal cancer screening rates among older, low-income Hispanics. (NMSU Agricultural Communications photo by J. Victor Espinoza)

The two-year examination of residents 50 to 79 years old living near La Clinica de Familia or Family Clinic in the far southern New Mexico communities of Chaparral and Anthony found that promotoras played a key role in explaining the importance of early detection of colorectal cancer, detailing what would happen during the screening process, and ultimately getting people in the clinic door.

During the study, 348 neighborhood residents were screened, representing about a third of the potential target population, said Ann Bock, a human nutrition professor at NMSU. The doctors found 4.8 percent tested positive for blood in the GI tract, one of the signs that the health care workers were looking for during their initial colorectal cancer screening.

"Ultimately, 33 individuals were referred for more extensive colorectal cancer testing," she said.

Colorectal cancer has long been an ailment that has remained unmentioned, primarily because of the "unmentionable" body part it affects. But this whispered disease will claim 57,000 lives this year in the United States alone.

"Certain minority populations are more prone to colorectal cancer, and one of those is Hispanics," Bock said. "Hispanics are also part of a population group that do not seek health care as often or get preventive health screenings as frequently compared with other population groups. That's why we turned inside the community for help in increasing colorectal screening levels."

The study was funded by the National Cancer Institute.

The NMSU research team chose the promotora model because of its success in close knit Hispanic communities. The promotoras were from the local community and more than likely knew the patient's family, Bock said. In addition, they spoke the same language and were of a similar age.

As part of the experiment, an introductory letter explaining the colorectal screening program was mailed by the promotoras. This was followed up with phone calls and in some cases home visits.

"We found this model to be very effective," Bock said. "In this case, people didn't go to the health care source. It came to them."

Another method of community participation came in the form of posters and radio public service announcements, as well as area health fairs, where an award-winning colorectal screening brochure developed by NMSU and the Fred Hutchinson Cancer Research Center was distributed.

The Spanish and English handout provided patient instructions for taking a three-part test. The screening, known as a fecal occult blood test, uses a chemical process to check the stool for hidden blood.

Bock's goal now is to continue refining NMSU's promotora and colorectal literature, radio spots and posters for more minority groups to improve screening rates. "In almost every kind of disease situation if you can prevent it or catch it early, the costs associated with health
care are going to be much less than at an advanced stage," she said.

Nationally, only about half of Americans 50 and older have been screened for colon and rectal cancer, which are diagnosed in about 147,000 U.S. residents each year and kill almost 40 percent of them.

"Colorectal cancer is not just a disease that affects older men," Bock said. "Women are diagnosed as often as men, and many of them in the prime of their lives."