“Sorry for laughing, but it’s scary”: humor and silence in discussions of Colorectal Cancer with Urban American Indians

• Main Authors: Buchwald, Dedra S, Bassett, Deborah R, Van Dyke, Emily R, Harris, Raymond M, Hanson, Jessica D, Tu, Shin-Ping
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: eScholarship, University of California 2023
• Subjects: Biomedical and Clinical Sciences; Public Health; Health Sciences; Clinical Sciences; Clinical Research; Cancer; Arctic; Rural Health; American Indian or Alaska Native; Colo-Rectal Cancer; Behavioral and Social Science; Digestive Diseases; Prevention; Good Health and Well Being; Aged; Female; Humans; Male; Colorectal Neoplasms; Early Detection of Cancer; Focus Groups; Wit and Humor as Topic; Urban Population; Alaska Natives; American Indians; Cancer screening; Colorectal cancer; Ethnography; Gender; Health communication; Health disparities; Qualitative research; Oncology and Carcinogenesis; Public Health and Health Services; Oncology & Carcinogenesis; Epidemiology; Indian; Pacific; Alaska
• Online Access: https://escholarship.org/uc/item/2t54r3dp

BackgroundGiven high rates of cancer mortality in Native communities, we examined how urban American Indian and Alaska Native elders talk about colorectal cancer (CRC) and CRC screening.MethodsWe conducted seven focus groups with a total of 46 participants in two urban clinics in the Pacific Northwest to assess participant awareness, perceptions, and concerns about CRC and CRC screening. Using speech codes theory, we identified norms that govern when and how to talk about CRC in this population.ResultsOur analyses revealed that male participants often avoided screening because they perceived it as emasculating, whereas women often avoided screening because of embarrassment and past trauma resulting from sexual abuse. Both men and women used humor to mitigate the threatening nature of discussions about CRC and CRC screening.ConclusionsWe offer our analytic results to assist others in developing culturally appropriate interventions to promote CRC screening among American Indians and Alaska Natives.