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To screen or not to screen: A key decision that reflects health literacy and trust

  • Joy E. Obayemi
    Affiliations
    Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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  • Gifty Kwakye
    Correspondence
    Corresponding author. Division of Colorectal Surgery University of Michigan, 1500 E. Medical Center Drive 2922 Taubman Drive, Ann Arbor, Michigan, 48109-5300, USA.
    Affiliations
    Department of Surgery, University of Michigan, Ann Arbor, MI, USA
    Center for Global Surgery, University of Michigan, Ann Arbor, MI, USA
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Published:November 11, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.11.006
      The choice to participate in cancer screening is more complex than it may seem and often reflects a multifactorial decision made by patients in an individual social context. While screening remains a vital means of detecting early-stage malignancy, facilitating appropriate treatment, and improving cancer-related survival, it requires that a clinically well and asymptomatic individual voluntarily engage with the healthcare system. As Dr. Fayanju and her colleagues adeptly highlight in their study, large swaths of the population – often patients from low socioeconomic backgrounds, immigrants, and ethnic minorities – have low rates of cancer screening participation.
      • Fayanju O.M.
      • et al.
      Modifiable Patient-Reported Factors Associated with Cancer-Screening Knowledge and Participation in a Community-Based Health Assessment.
      • Adams L.B.
      • et al.
      Medical mistrust and colorectal cancer screening among african Americans.
      • Hall I.J.
      • et al.
      Patterns and trends in cancer screening in the United States.
      Due to historical mistreatment and exploitation of these communities by the American healthcare system, these groups often have generations of trauma and justified mistrust of clinicians that can result in hesitancy to engage in cancer screening and may perpetuate disparities in cancer detection and outcomes. The authors of this study attempt to identify modifiable system and patient factors that could provide opportunities for intervention and improvements in screening habits, especially among these key populations.
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