Background: Beliefs influence cancer screening. However, there are conflicting findings about how belief influence cancer screening among Black adults. The aim of this study was to evaluate the relationships between beliefs (religiosity, fatalism, temporal orientation, and acculturation) and cervical, breast, and colorectal cancer screening behaviors among African Americans and sub-Saharan African immigrants. Methods: We conducted a cross-sectional survey of 73 African American and 59 English speaking Sub-Saharan immigrant adults recruited from Lexington and surrounding cities in Kentucky. Data collected included sociodemographic variables, cancer screening behaviors, and several instruments that characterize beliefs, including religiosity, fatalism, temporal orientation, and acculturation. Results: Participants’ mean age was 43.73 years (SD = 14.0), 83% were females, and 45% self-identified as sub-Saharan immigrants. Based on eligibility for each screening modality, 64% reported having ever had a Pap test, 82% reported ever having mammogram, and 71% reported ever having a colonoscopy. Higher education (OR = 2.62, 95% CI = 1.43—4.80) and being insured (OR = 4.09, 95% CI = 1.10 – 15.18) were associated with increased odds of cervical cancer screening (pap test), while cancer fatalism (OR = 0.24, 95% CI = 0.07 – 0.88) was associated with decreased odds. Increased age (OR = 1.57, 95% CI = 1.06 – 2.32) and reduced present orientation (OR = 0.42, 95% CI = 0.22 – 0.80) were associated with receipt of a mammogram. Nativity was the only factor associated with colonoscopy screening. Compared to African Americans, sub-Saharan African immigrants were 90% less likely to have had a colonoscopy (OR = 0.10, 95% CI = 0.02 – 0.66). Conclusion: This study contributes to the existing literature by confirming that beliefs are important in cancer screening behaviors among African American and sub-Saharan African immigrants. These findings should inform the development of cancer control and prevention programs for Black adults. Trial registration: US National Library of Science identifier NCT04927494. Registered June 16, 2021, www.clinicaltrials.gov.

Original languageEnglish
Article number2219
JournalBMC Public Health
Issue number1
StatePublished - Dec 2022

Bibliographical note

Funding Information:
This research was supported by a National Institutes of Health National Cancer Institute grant (K01CA251487: Adegboyega). Support for the use of REDCap was provided by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Publisher Copyright:
© 2022, The Author(s).


  • Acculturation
  • Beliefs
  • Cancer screening
  • Fatalism
  • Religiosity
  • Temporal orientation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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