Barriers to Colorectal Cancer Screening in a Racially Diverse Population Served by a Safety-Net Clinic

• Published in: Journal of community health Vol. 42; no. 4; pp. 791 - 796
• Main Authors: Nagelhout, Elizabeth, Comarell, Kristen, Samadder, N. Jewel, Wu, Yelena P.
• Format: Journal Article
• Language: English
• Published: New York Springer Science + Business Media 01.08.2017; Springer US; Springer Nature B.V
• Subjects: Adhesion; Age; Age Factors; Aged; Cancer; Cancer screening; Colon; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - ethnology; Community and Environmental Psychology; Continental Population Groups; Cross-Sectional Studies; Demographics; Early Detection of Cancer - statistics & numerical data; Ethics; Ethnicity; Fatalities; Fear; Female; Health behavior; Health care access; Health Knowledge, Attitudes, Practice; Health Promotion and Disease Prevention; Humans; Logistic Models; Male; Medical screening; Medicine; Medicine & Public Health; Middle Aged; Minority & ethnic groups; ORIGINAL PAPER; Pacific Islanders; Patients; Populations; Race; Races; Safety-net Providers - statistics & numerical data; Sex Factors; Test Results; Patient barriers; Racial disparities; Colorectal cancer; Cancer screening; Patient awareness
• ISSN: 0094-5145; 1573-3610
• DOI: 10.1007/s10900-017-0319-6

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the US, yet screening rates remain low among minority populations. The purpose of the current study was to identify differences in the endorsement of barriers to CRC screening and to evaluate the association between provider recommendation and CRC screening adherence among Hispanic, Pacific Islander and White patients. This study utilized a cross sectional survey design to identify patient-reported barriers to CRC screening. Logistic regression was utilized to evaluate the association between patient demographic characteristics (race/ethnicity, gender, age), having received provider recommendation, and patient awareness of CRC screening. The study sample was comprised of a diverse population (N = 197); 48% Hispanic, 25% White, 10% Pacific Islander, 4% Black and 13% other races/ethnicity. The median age of participants was 58, yet fewer than 30% were up-to-date for CRC screening. The most commonly cited barriers included fear of test results (27.6%), inability to leave work for a CRC screening appointment (26.9%), being unaware of the need for colonoscopy (25.4%), and lack of provider recommendation for CRC screening (24.9%). Only 16.2% of participants reported that a provider had discussed CRC screening options with them. After adjusting for age and gender, Hispanic patients were less likely to report having had a provider discuss CRC screening options compared to White patients (OR = 0.24, 95% CI: 0.09–0.68, p < 0.05). The findings from this study indicate that patient’s perceived screening barriers, lack of awareness and a lack of provider communication about CRC screening options may contribute to low screening rates among minority populations.