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Social Ties and Colorectal Cancer Screening among Blacks and Whites in North Carolina

¹ College of Nursing, ² Huntsman Cancer Institute, and ³ Department of Psychology, University of Utah, Salt Lake City, Utah and ⁴ Division of Digestive Diseases and Nutrition, Center for Gastrointestinal Biology, ⁵ Department of Epidemiology, School of Public Health, and ⁶ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Requests for reprints: Anita Yeomans Kinney, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112. Phone: 801-585-1151; Fax: 801-581-4642. E-mail: anita.Kinney{at}hci.utah.edu

Few studies have examined the relationship between social networks and colorectal cancer screening in diverse populations. Prior research suggests that the type of social support as well as the amount or frequency of support available from one's social network may be associated with health outcomes. Therefore, the current study examined relationships between both structural (i.e., quantitative aspects of the social network, such as number of ties and frequency of contact with ties) and functional (i.e., functions provided by social network ties, such as offering emotional or instrumental support) aspects of social ties and utilization of colorectal cancer screening tests. Analyses included 697 randomly selected Blacks and Whites ages 51 to 80 years enrolled as controls in the North Carolina Colon Cancer Study. Social tie and screening information was obtained from face-to-face interviews. Forty-seven percent of participants (40% Blacks and 51% Whites) reported use of one of the options for colorectal cancer screening according to the guidelines at that time. Compared with those with the fewest social connections, those who were most socially connected were more likely to report recent use of colorectal cancer screening [odds ratio (OR), 3.2; 95% confidence interval (95% CI), 1.7-6.2]. This association was stronger among Blacks (OR, 3.8; 95% CI, 1.3-10.7) than Whites (OR, 2.9; 95% CI, 1.2-6.9; P for interaction = 0.006). There were also positive associations between being a church group (OR, 1.9; 95% CI, 1.4-2.7) and other group member (OR, 1.6; 95% CI, 1.1-2.2) and screening. Neither emotional (e.g., offering reassurance that one is cared for) nor instrumental (e.g., giving material assistance) support was associated with screening behavior. These data suggest that structural rather than functional aspects of social ties may be important in influencing colorectal cancer screening behavior.

Key Words: colorectal cancer • screening • social networks • social support • social ties • Blacks

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