Cancer Screening in Appalachia: A Common-Sense Approach

Background: The Appalachian region in the USA has some of the highest rates of cancer and cancer mortality in the country, due in part to suboptimal screening. Routine screening for cervical and colorectal cancer can decrease cancer morbidity and mortality. The current study sought to assess the feasibility and preliminary impact of an intervention guided by the Common-sense Model of Self-regulation to improve cervical and colorectal cancer attitudes and screening intentions. Method: Participants were approached in safety net clinics in Appalachian communities. Individuals completed surveys before and after an intervention that was designed to address lay understandings about the risks and causes of cervical and colorectal cancer and screening. Interventions were conducted with up to three family members, but at least one person in the family was not within screening guidelines. Paired t-tests assessed the impact of the intervention. Results: Participants (n = 121) were predominantly women (76.0%) and White (69.4%) and had incomes of $20,000 or less (69.4%). Overall, screening barriers were moderate and did not change after the intervention. In response to the intervention, perceived risk and cervical cancer causes (risk factors) became more accurate, individuals increased in knowledge of colorectal cancer screening, the perceived deadliness of cervical and colorectal cancers decreased, intentions to screen increased, and the appraisal of the effectiveness of screening increased (all p’s < 0.05, Holm adjusted). Conclusion: The intervention had a positive impact on lay understanding of cervical and colorectal cancer and increased intentions to have cancer screening. A larger, randomized control trial is merited to investigate the impact of the intervention on screening rates.