Exploring Cultural and Age-Specific Preferences to Develop a Community-Based Colorectal Cancer Screening Intervention for CHamorus and Filipinos in Guam—Findings from a Qualitative Study

Tressa P. Diaz (), Santino G. Camacho, Elizabeth J. Elmore, Corinth T. Aguon and Angela Sy
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Tressa P. Diaz: Cancer Research Center, University of Guam, Dean’s Circle #7, 303 University Drive, Mangilao, GU 96923, USA
Santino G. Camacho: School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA 98105-6250, USA
Elizabeth J. Elmore: Margaret Perez Hattori-Uchima School of Health, University of Guam, UOG Station, Mangilao, GU 96923, USA
Corinth T. Aguon: Cancer Research Center, University of Guam, Dean’s Circle #7, 303 University Drive, Mangilao, GU 96923, USA
Angela Sy: John A. Burns School of Medicine, University of Hawai‘i at Manoa, 651 Ilalo Street, Honolulu, HI 96813, USA

IJERPH, 2025, vol. 22, issue 5, 1-17

Abstract: The decline in colorectal cancer (CRC) due to screening success in the U.S. is inconsistent across populations and age groups. CHamorus (Chamorros) and Filipinos constitute minorities in the U.S. but comprise over 70% of the population in Guam where steep increases in CRC incidence occur before the age of 50, and only 53.9% of persons have met national screening standards. This preliminary study explored knowledge, cultural beliefs, and age-specific recommendations associated with CRC and screening. Five focus groups segregated by age and gender were conducted with persons aged 40 and above. Data were collected on knowledge, attitudes, beliefs, and screening education recommendations. Focus group participants ( n = 25) were predominantly CHamoru (60%), Filipino (32%), and female (56%). The mean age was 55. Participants preferred interventions that integrated storytelling from CRC survivors with emphasis on family education rather than limiting to screening-age adults. Multicoders performed an iterative collaborative analysis for the main themes: knowledge of CRC/screening primarily derives from family experiences; increased outreach is needed for men; use of personal narratives; and screening is motivated by family values and intergenerational consciousness. Findings can inform future studies on age- and culturally-tailored early detection strategies to improve CRC screening participation in Pacific populations.

Keywords: colorectal cancer; cancer disparities; Pacific Islander; cancer screening education; cultural beliefs; Chamorro; Filipino; Guam (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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