Cancer-related knowledge, attitudes, and behaviors among Chamorros on Guam

Background: Cancer is the second leading cause of death among Chamorros, the indigenous population of Guam. This study assessed cancer-related knowledge, attitudes, and preventive behaviors (KAB) among Chamorros on the island. Methods: We conducted a self-administered English language survey regarding cancer-related KAB using a non-probability purposive sample design in 266 self-identified Chamorros (149 women and 117 men) over the age of 50 years. The survey included demographics; health status; access to medical care; and KAB about breast, cervical, prostate, colorectal, lung, and nasopharyngeal cancer. Descriptive statistics and bivariate analysis were used to assess the data. Results: Overall, 83.3% of women reported having a mammogram and 62.8% reported having a Pap smear within the past 2 years. Only 20.3% of men reported having a prostate specific antigen (PSA) test within the past year. Of concern, only 43.1% had heard of PSA. Only 38.3% of participants reported ever having fecal occult blood testing, 15.5% ever having sigmoidoscopy, and 33.1% ever having colonoscopy. Respondents who had a regular source of care were more likely to receive up to date mammography screening (p < 0.01). Likewise, those who had visited their doctor within the past year were more likely to be screened for breast (p < 0.01), cervical (p < 0.05), prostate (p < 0.01), and colorectal cancer (p < 0.05). In addition, residents living in the south were less likely to report screening for breast (p < 0.05), prostate (p < 0.05), and colorectal (p < 0.01) cancer. Conclusion: These results provide important data about Chamorro's KAB that can help to guide a comprehensive cancer control program on Guam.