# 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

## TL;DR

This study explores how cultural and age-specific preferences can improve colorectal cancer screening among CHamorus and Filipinos in Guam.

## Contribution

The study identifies community-specific strategies, such as storytelling and family education, to enhance CRC screening participation in Pacific populations.

## Key findings

- Participants preferred interventions using CRC survivor stories and family education.
- CRC knowledge primarily comes from family experiences, highlighting the role of intergenerational communication.
- Outreach efforts should focus on men and use personal narratives to increase screening motivation.

## 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.