The goal of increasing participation in colorectal cancer screening for poor, elderly, black individuals is both a state and a national priority. Unfortunately, these individuals are least likely to participate in screening.

This descriptive, correlational study reports on the relationship between selected demographic factors, fatalism, knowledge of colorectal cancer, and participation in fecal occult blood testing among poor, elderly individuals. Fatalism is the belief that death is inevitable when cancer is present.

A randomly selected sample (N = 192) were recruited from South Carolina Council on Aging Congregate Meal Sites. Data were collected using a demographic questionnaire, the Powe Fatalism Inventory, the Colorectal Cancer Knowledge Questionnaire, and Hemoccult II kits. Correlations, t-tests, stepwise multiple regression, and stepwise logistic regression were used to analyze the data.

Only 30% of the sample participated in FOBT. The typical fatalistic individual was black, female, had decreased education, annual income below the poverty level, and decreased knowledge of colorectal cancer. Fatalism was a significant predictor of participation in FOBT. In fact, when fatalism was added to the statistical model, other previously supported predictors such as demographic factors and knowledge of colorectal cancer lost their significance. These findings strongly suggest that fatalism alone can be used to predict participation in FOBT for this sample.