Barriers To Colorectal Cancer Screening Research Articles

Abstract A133: The Church Study: Bridging the gap in colorectal cancer screening of Black patients

Abstract Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death in the US, disproportionately affecting Black Americans with a 25% higher risk and 40% greater mortality than non-Hispanic White Americans. Data on CRC screening preferences among Black patients is limited. We conducted a survey to evaluate CRC screening preferences and barriers to screening after a culturally tailored educational talk among Black churchgoers. Aim: The aim of this study is to assess the preferences and barriers to CRC screening among Black Americans, utilizing culturally tailored educational interventions to enhance screening uptake. Methods: Participants aged 45-85, at average CRC risk, were recruited from three predominantly Black churches in disadvantaged areas of Atlanta, excluding high-risk individuals and those outside the age range. CRC education, vetted for cultural sensitivity, was provided. Informed consent was waived by Morehouse IRB but ensured through educational sessions with opportunities for questions. A 30-question survey covered Demographics, Medical History, Screening Experience, and Preferences. Participants received a $25 Amazon gift card post-survey. Descriptive statistics were applied to demographics and CRC screening preferences, categorized per NCCN guidelines. Results: Out of 101 participants, 64% preferred blood-based screenings and 19% preferred fecal-based testing. Over 73% reported being up-to-date with CRC screening, with more than 61% having a colonoscopy as their most recent CRC screening test. Additionally, 30% of participants were willing to be CRC awareness advocates. Healthcare provider access was high, with 94% reporting having a primary care provider. Trust in providers was approximately 92%, with 4% expressing distrust and 4% uncertain. Conclusions: Despite being in underserved areas, participants reported no significant barriers to CRC screening, with most up-to-date on prevention. Their active participation and willingness to advocate underscore the effectiveness of church settings in health education for Black communities. Preferences for blood-based screenings indicate openness to less invasive options, highlighting the need for tailored interventions. High trust in healthcare providers challenges the narrative of mistrust among African Americans, demonstrating that culturally sensitive, community-focused engagement enhances preventive health participation. The willingness of 30% to become CRC awareness advocates demonstrates strong potential for community-driven health initiatives. Citation Format: Toni M. Jackson, John Onyekaba, Kingsley K. Njoku, Ankita Shah, Carrie Smith, Chima Amadi, Kapil Chandora, Daniela Ortegasantori, Hafsa Gundroo, Temitope Tobun, Daniel Hommes, Julia Liu. The Church Study: Bridging the gap in colorectal cancer screening of Black patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A133.

Factors Affecting Colorectal Cancer Screening in Primary Care Physician Practices in Ukraine.

This study aims to identify the factors influencing colorectal cancer (CRC) screening practices, along with the barriers and facilitators from the perspective of primary care physicians (PCPs) in Ukraine. Considering health care system challenges, including those posed by the ongoing war, this research seeks to inform improvements in CRC screening and outcomes in Ukraine and other low- and middle-income countries (LMICs). A survey was designed and distributed electronically to Ukrainian PCPs, focusing on CRC screening practices, beliefs, and barriers. The survey incorporated questions adapted from established cancer screening surveys and frameworks. Complete responses were collected from 740 PCPs. Sample statistics were computed, and population-level perceptions and associations with CRC screening practices were estimated by standardizing responses to national PCP demographics. The majority of respondents were women (91%) and specialized in family medicine (84%). Respondents believed in the effectiveness of colonoscopy for reducing CRC mortality (80%), with 75% of PCPs referring patients for this screening modality. Major barriers identified include inadequate training of PCPs in screening and lack of resources. Respondents reported high utilization of fecal occult blood test and colonoscopy for screening when these tests were said to be available in their practices. Self-reported familiarity with CRC screening guidelines and participation in educational workshops were positively associated with screening referrals. The study highlights the role of access to CRC screening tests and awareness of screening guidelines in enhancing CRC screening practices among Ukrainian PCPs. Addressing training and resource barriers, alongside public health interventions targeting patient-related barriers, is essential. These findings offer valuable insights for LMICs facing similar challenges, emphasizing the need for tailored strategies to improve cancer screening in these health care settings.

Engaging the community on colorectal cancer screening: Additional factors identified by African Americans as potential barriers during focus groups

ObjectiveAfrican-Americans have the highest rate of colorectal cancer deaths. Adherence to colorectal cancer screening guidelines can improve outcomes. The objective of this study was to evaluate physician trust and barriers to screening utilizing a unique bi-directional learning focus group involving African-American adults and health care learners. MethodsA focus group of African-American adults from a community church and university health care learners was conducted to identify colon cancer screening barriers. Health care learners were medical students, resident physicians and gastroenterology fellows. Pre-focus group surveys, including the Wake Forest Physician Trust Scale (WFPTS) and a colon cancer screening knowledge survey, were administered. Audio recording of the focus group was transcribed with subsequent thematic analysis. A post-focus group survey evaluated the colorectal cancer screening barriers identified during the focus group. Analysis of pre- and post- focus group surveys was performed using Fisher Exact test with significance set at p<0.05. ResultsThe focus group consisted of 18 members (7 African-American community members, 11 non-African American health care learners). WFPTS revealed that 83% (86% community members, 82% health care learners; p = 1.0) strongly agree / agree that their physician would advocate for their health. 77% (86% community members, 73% health care learners; p = 1.0) strongly agree / agree that they trusted their physician. 100% recognized that colon cancer screening is recommended. The focus group identified lack of awareness (81%), colonoscopy preparation (81%), trust in physician (60%), lack of insurance coverage (56%), transportation (56%), colonoscopy wait time (50%), insufficient physician discussion (50%) and fear of procedure or cancer (35%) as screening barriers. Post-focus group surveys revealed that community members more frequently identified racial disparity in health care (p = 0.0474), physician respect toward patients (p = 0.0128) and insufficient physician discussion (p = 0.0006) as screening barriers. ConclusionsFocus group discussion identified multiple barriers for colorectal cancer screening. Notably, differences in the perceptions of African-American community members and non-African-American health care learners about racial disparity in health care, physician respect toward patients and insufficient physician discussion were revealed. The integration of bi-directional focus group learning can be considered as a potential strategy to assist in the development of focused screening interventions.

Knowledge and awareness about colorectal cancer and barriers to its screening among a sample of general public in Saudi Arabia.

The present study investigated knowledge, awareness, and barriers to colorectal cancer (CRC) screening from a sample of the general population in Saudi Arabia. This cross-sectional study was conducted between August 2022 and January 2023 among a sample of the general population in Jeddah, Saudi Arabia. The questionnaire consisted of demographics, knowledge and awareness, and questions about CRC screening barriers. A total of 1105 adults belonged to the general public [505 females (45.7%) and 600 males (54.3%)] recruited in this survey. The mean age of the respondents was 39.79±12.49. The internet was the primary source of CC information for most participants, 661(59.8%). Gender-wise comparison of general public responses regarding CRC knowledge and awareness and barriers to screening showed a mixed response. Analysis of participants' knowledge regarding CRC and its risk factors and warning signs showed that 356(32.2%) people believed that the best age for the CRC test is 41-50 years, and 285(25.8%) responded they don't know. Almost half of the participants, 539(48.8%), were not interested in attending awareness seminars about CRC, while 371(33.6%) were interested in attending awareness seminars about CRC. Only one-third of the respondents, 368(33.3%), knew of any tests or examinations used to detect CRC. Participants' perceptions about colonoscopy-related and FOBT-related barriers to CRC screening disclosed that these are time-consuming, expensive, painful, embarrassing, etc. Insufficient information, poor awareness, and several assumed barriers to CRC screening were found among study participants. There is a need to close knowledge gaps and offer them comprehensive information regarding CRC, as well as the availability and benefits of screening. In this aspect, social media can be extremely beneficial.

Knowledge, attitude, practice, and perceived barriers of colorectal cancer screening among primary care physicians in the Kingdom of Bahrain

Background: Colorectal cancer (CRC) is one of the lethal cancers all over the world. Early detection of colorectal cancer has been shown to reduce incidence and mortality. Primary care physicians have a crucial role in early detection of cancer. This study aims to explore the knowledge, attitude and practice of primary care physicians in Bahrain towards CRC screening and to determine the barriers related to CRC screening. Methods: A cross sectional study was carried out among primary care physicians working at primary health care centers in Bahrain. It included 174 physicians. A self-filled questionnaire that includes demographic information, knowledge scale, attitude scale, practice scale items and barriers of not performing CRC screening was used as the study tool. Results: The overall knowledge score revealed that 51.7% had poor knowledge score and 48.3% had adequate knowledge score. Majority of the participants (93.7%) agreed to have a structured screening program for colorectal cancer rather than an opportunistic one. Most of the physicians (60%) reported that less than 25% of those eligible patients truly receive a screening. Physician’s lack of time was the top barrier of not performing CRC screening. Conclusions: This study showed that most primary care physicians have poor knowledge regarding CRC screening and the majority do not screen their eligible patients for CRC.

Colorectal cancer screening barriers and facilitators among Jordanians: A cross-sectional study

The factors affecting the adherence of Jordanians to colorectal cancer (CRC) screening remain underexplored. We examined the inhibitory and facilitating factors that influence the uptake of CRC screening among Jordanians. We conducted questionnaire interviews between April 2020 and June 2021 with 861 Jordanians aged 50–75. We analyzed the differences between proportions using the chi-square test. Binary logistic regression was conducted to determine factors associated with awareness of CRC and its screening. Of all participants, 41.7 % were aware of the necessity of screening for CRC, and 27.2 % were aware of at least one of the tests for CRC screening. However, only 17.2 % of participants underwent screening. In the multivariate analysis, participants with higher income (p-value < 0.001, odds ratio[OR] = 1.9, 95 % confidence interval [CI]: 1.4–2.7), higher level of education (p-value < 0.001, OR = 2.6, 95 % CI: 1.8–3.7), family history of colon cancer (p-value < 0.001, OR = 2.8, 95 % CI = 1.7–4.5), and those who had been screened for other cancers (p-value = 0.003, OR = 1.7, 95 % CI: 1.2–2.5) were more aware of the necessity of screening. Concerning barriers to screening, 'feeling well,' lack of physician endorsement, and difficult access to health care were the most commonly reported inhibitory factors (53.9 %, 52.3 %, and 31.9 %, respectively). The most commonly stated incentivizing factor was physician endorsement (82.3 %). Screening rates for CRC in eligible Jordanians remain low, albeit more than one-third of participants are aware of the necessity of screening. Enhanced awareness of barriers and incentivizing factors should help to prioritize national strategies to improve screening rates.

Abstract A036: Associations between area-level social determinants and late-stage diagnosis of colorectal cancers

Abstract Introduction Systemic policies and disinvestment in some communities have created deep inequities in the social and economic conditions in which some communities live. There are documented disparities in the detection and diagnosis of colorectal cancer (CRC) and stage-appropriate treatment, which drives cancer outcomes, such as survival. Using the Andersen-Aday model of access to healthcare, prior researchers have identified person-specific factors associated with late-stage diagnosis. In this study, we investigated whether area-level measures that may related to CRC screening barriers were associated with late-stage CRC diagnoses. Methods We used data from the Surveillance, Epidemiology, and End Results (SEER) and selected cases of adult (18+ years) colorectal cancer diagnosed from 2006-2013 (most recent years available; n=234,232). This data was linked to Medicaid enrollment information. We merged census-tract level data from the American Community Survey (2010 midpoint) capturing transportation access (% utilizing public transit for commuting), housing quality and cost (more than 1 person occupying per room and rent &amp;gt; 30% of income), language proficiency (% speaking English less than well), receipt of SNAP benefits, as well as poverty rate and educational attainment (% in tract attaining a high school education or less). We tested these variables as separate multivariable logistic regression models using late-stage CRC diagnosis (AJCC Stage IV vs Stages 0-III) as the dependent variable to test the association between each area factor, controlling for age, sex, race, marital status, and others. Results In all, 24% of CRC cases were diagnosed in Stage IV. High poverty areas (20+% poverty compared vs. &amp;lt;5% poverty OR = 1.10, CI: 1.07-1.15) and areas with lower educational attainment (lowest educational quartile vs. highest OR = 1.11 CI: 1.07-1.15) are associated with higher odds of Stage IV CRC diagnosis. Areas utilizing more public transit (most use quartile vs. least use quartile, OR = 1.04, CI: 1.01-1.07) and more SNAP benefits (most use vs. least use quartile, OR = 1.13, CI = 1.09-1.17), are also associated with higher odds of Stage IV diagnosis. High occupancy housing areas were associated with higher odds of Stage IV CRC diagnosis (highest occupancy quartile vs. lowest OR = 1.04, CI = 1.01-1.07), while affordability of rent was not. Area-level English proficiency was also not associated with later diagnosis. Conclusions Area-level social determinants are important factors in CRC detection and control. Early diagnosis is a key factor in better survival after CRC. It is important to understand specifically which area-level factors are most important in early detection to inform interventions to reduce disparities in late-stage CRC diagnosis. Citation Format: Manami Bhattacharya, Lindsey Enewold, Amy Davidoff. Associations between area-level social determinants and late-stage diagnosis of colorectal cancers [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A036.

Development of a colorectal cancer screening intervention for Alaska Native people during a pandemic year

ObjectivesAlaska Native (AN) people experience twice the rate of colorectal cancer (CRC) as US Whites. There is a need for increased screening and early detection. We describe the development and implementation of a randomized controlled trial of the multi-target stool DNA test (mt-sDNA; Cologuard® Exact Sciences, Madison WI) to increase CRC screening among AN people. MethodsA total of 32 rural/remote AN communities were randomized to a varied intensity intervention (patient navigation vs mailed health education) compared to 14 communities receiving usual opportunistic care. Outcome measures include screening completion and method used (mt-sDNA vs colonoscopy). Health care provider interviews and AN patient focus groups will be used to assess patient-, provider-, and system-level CRC screening promoters and barriers. ResultsThe study began in April 2020 during the COVID-19 pandemic, resulting in a number of challenges and study adaptations. These included difficulty finding laboratory space, lack of timely mail service due to flight reductions across the state, and travel restrictions that led to postponement of in-person focus groups. Videoconferencing platforms for Tribal engagement replaced face-to-face interactions. After an extensive search, a laboratory with space available was identified and the preprocessing laboratory established. Study staff will work closely with patients to monitor mail service to get mt-sDNA kits sent on time. We are also exploring the use of videoconferencing platforms as alternatives to in-person focus groups. ConclusionsDespite the challenges encountered during the COVID-19 pandemic, we successfully initiated the intervention and established the first mt-sDNA preprocessing laboratory in Alaska.

Development of a Computer-Tailored Intervention/Decision Aid To Increase Colorectal Cancer Screening in Health Systems.

BackgroundNon-compliance with scheduled colonoscopy is common among patients, especially in underserved populations. High no-show and late cancelation rates result in wasted resources, increased costs, and missed opportunities for colorectal cancer (CRC) screening. Among the barriers to colonoscopy is a lack of knowledge about the benefits, fears, and limited time for patient counseling.MethodologyWe produced a digital video disc and a website program to enhance awareness about CRC screening and address patient barriers in a population with low screening adherence.ResultsPatients can be educated via an interactive computer-tailored intervention with both DVD and web versions. It details the benefits and need for CRC screening, different methods of screening, and addresses patient-related barriers.ConclusionsPatient education is crucial to increase CRC screening among eligible individuals. Because online engagement is affected by attention, interest, and affect, content should be concise but comprehensive.

Identifying the main barriers for participation in a population-based colorectal cancer screening programme in East Azerbaijan, Iran.

BackgroundColorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide. However, CRC is considered as one of the most preventable cancers by which the mortality rates reduce about 60% through implementing the screening programmes. The present study aimed to evaluate the main barriers of CRC screening in a defined population.MethodHealthy individuals from all regions of the state were invited to participate in different healthcare centres. They were assessed by a provided online risk assessment tool, which was completed for all recruited subjects, and has been developed to assess the CRC risk based on personal and family history of adenoma, CRC, and other high-risk diseases. Research team staff assessed all individuals by this tool and then eligible people according to their lifetime risk of CRC were included in the study. There was not any age restriction in this study. Colonoscopy and three stool-based tests including faecal occult blood test, faecal immunochemical test and stool DNA tests were performed.ResultsOverall, 725 cases including 425 (58.6%) males and 300 (41.4%) females participated in the study. Lack of knowledge and attitude about screening programmes was the most common barrier, especially among women (68% for women versus 58% for men) and those from rural areas (88% in rural versus 55% in urban areas). Fear of colonoscopy and procedure complications and pain (48%), discomfort and anxiety from inserting a tube into the bowel (65% among females versus 43% among males) were reported commonly. Embarrassment and dignity were other complaints, especially in women (62% in females versus 35% in males).ConclusionIncreasing knowledge and attitude about the aims and benefits of screening programmes, acceptable and convenient communication of health systems with the general population are considered to be the key elements in the success and implementation of any screening programme.

Colorectal cancer community engagement: a qualitative exploration of American Indian voices from North Dakota

BackgroundAmerican Indians (AI) in North Dakota present with higher rates of advanced-stage disease for screening detectable colorectal cancers and have lower overall baseline colorectal cancer screening rates than non-AIs. We sought to identify the perceived barriers and facilitators for the engagement with colorectal cancer prevention within North Dakota tribal communities.MethodsTwelve semi-structured interviews were carried out across four tribal reservation communities in the state of North Dakota with American Indian adults between the ages of 30 and 75 years. We utilized purposive sampling to ensure maximum variation in age, sex, and tribal community until data saturation was achieved. The interviews were transcribed, and thematic analysis was carried out to identify consistent themes rooted within the data. Ethical approval was gained for this project from all relevant institutional review boards.ResultsFour main themes were identified as barriers for the engagement with colorectal cancer prevention, including: colorectal cancer screening barriers, focused on other health problems, lack of colorectal cancer tailored health promotion, and socio-cultural factors affecting colorectal cancer prevention. Three main themes were identified as facilitators for the engagement with colorectal cancer prevention, including: reasons for getting colorectal cancer screening, role of culture, and getting out into the community.ConclusionThere is need for more community-rooted, strengths-based approaches to colorectal cancer prevention activities in AI communities in North Dakota. Socio-cultural factors, such as the use of storytelling, and the use of traditional knowledge have been demonstrated to be an important element of consideration for colorectal cancer tribal community engagement and prevention planning in the state.

Cross-sectional Study of Colorectal Cancer Screening Barriers in a Latino-Serving Federally Qualified Health Center.

Compared to other races/ethnicities, the Latino population has a lower rate of adherence to colorectal cancer (CRC) screening guidelines. Previous studies have identified a variety of barriers to CRC screening in Latino populations but have not explored factors associated with barriers. The purpose of this study was to identify barriers to CRC screening and associated factors in a Midwest Latino population visiting an urban Federally Qualified Health Center (FQHC). We conducted a cross-sectional investigation of 68 Latinos at a FQHC from June to October 2017. We examined factors associated with scheduling, psychological, and financial barriers using t-test, ANOVA, and multiple linear regression analyses. Our participants reported low educational level, low income, and limited access to insurance or a primary care provider. Scheduling barriers are the highest barrier compared with psychological and financial barriers. Being married or coupled was the only predictor of higher scheduling barriers (P < .05). Being married or coupled was associated with higher psychological barriers in both univariate and multivariate analysis (P < .05). Higher education level was associated with higher psychological barriers in univariate (P < .05) but not multivariate analysis. Participants with lower vs. higher English proficiency had a higher financial barrier score in univariate (P < .05) but not multivariate analysis. Despite interventions targeting CRC screening barriers, including the provision of free at-home testing, perceived barriers persist. Bilingual patient navigators may help address needs for those with limited English proficiency to find and schedule free or reduced-fee colonoscopy services. People who are well educated are also at high risk of psychological barriers and should be targeted and given more education on the importance of CRC screening.

S3249 Identifying Colorectal Cancer Screening Barriers in a Resident Run Clinic

S3249 Identifying Colorectal Cancer Screening Barriers in a Resident Run Clinic

Developing a Novel Interactive Colorectal Cancer Educational Session for First-Year Medical Students to Enhance Interest in Public Health.

Medical students need more exposure to and a greater understanding of their role in public health throughout their training, which may influence more of them to pursue careers in public health or change how they practice medicine in the future. A novel colorectal cancer education session was created for first year medical students to attempt to increase public health interest, improve colorectal cancer knowledge and discuss barriers to colorectal cancer screening. We constructed a novel integrated interactive peer led colorectal cancer educational session of panelists with a wide range of experiences in colorectal cancer and colorectal cancer screening. The session involved a didactic component, case presentation, and group exercises followed by assembly discussion. We surveyed first-year medical students over two consecutive years to assess their interest in public health, knowledge of colorectal cancer, and perceptions of barriers to colorectal cancer screening before and after the educational session. We also evaluated student satisfaction with the session. We compared the pre- and post-survey results to assess for changes in interest, knowledge and perceptions. 74.63% of students in 2018 and 67.7% in 2019 evaluated the session as excellent or good, with knowledge regarding colorectal cancer screening markedly increased after the educational session. Students reported knowledge and access to healthcare among the biggest patient barriers to colorectal cancer screening. Interest in public health increased by 7.5% and 5.6% in 2018 and 2019, respectively. The implementation of this interactive educational peer led exercise can increase interest in public health, improve knowledge of colorectal cancer prevention and facilitate discussions of colorectal cancer screening barriers. We hope to encourage other programs to adopt this preliminary model.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13187-021-02087-y.

Awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China: a cross-sectional study

ObjectiveTo assess the awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China.DesignA cross-sectional study was employed.SettingThis study was conducted in nine hospitals in Hunan province, China.ParticipantsIndividuals...

Assessing Colorectal Cancer Screening Barriers in Rural Appalachia

The age-appropriate colorectal cancer (CRC) screening rate in the rural Appalachian area is low compared with the national rate, which may account for the overall higher incidence of CRC in this area. The purpose of this study was to explore potential barriers to CRC screening in the West Virginia Appalachian area. A cross-sectional survey was designed to identify patient-reported barriers to CRC screening using the health belief model to assess their attitudes and behaviors. Autonomous paper-based surveys were randomly handed to individuals older than 50 years at various locations, including healthcare and nonhealthcare facilities. All of the responses were then categorized into two groups: the screened group and the unscreened group. Differences among both groups were statistically analyzed. There were three main areas that significantly accounted for the discrepancies between the screened and unscreened groups: perceptions of discomfort from screening tests, psychological and behavior deterrents in CRC screening and diagnosis, and limited resources for accessing care, especially transportation. In particular, psychological and behavioral deterrents in CRC screening appeared to play a role in promoting aversion to CRC screening. Lack of CRC screening awareness and knowledge may be responsible for fatalism regarding CRC and aversion to screening. Thus, multidisciplinary interventions that provide education about CRC screening, early intervention prognosis, and treatment options, as well as addressing systemic barriers to screening, such as assistance with scheduling, prep instructions, and transportation, can improve the screening rate in Appalachia and eventually lead to better outcomes through the early diagnosis of CRC.

Psychosocial determinants of colorectal Cancer screening uptake among African-American men: understanding the role of masculine role norms, medical mistrust, and normative support

ABSTRACT Objectives Despite having the highest colorectal cancer (CRC) incidence and mortality across all major racial/ethnic groups, African-American men consistently have poor CRC screening rates. Gendered and racialized beliefs and norms have been associated with African-American men’s lower medical assistance-seeking rates, but how these notions influence African-American men’s CRC screening practices merits further investigation. The purpose of this study was to examine the influence of psychosocial determinants of men’s health on CRC screening uptake among African-American men in three states. Design Participants were recruited via CuttingCRC.com and through culturally-tailored flyers, newspaper ads, and snowball sampling, among other methods. From April 2019-August 2019, 11 focus groups were conducted with English-speaking Black/African-American men who (a) were between ages 45-75, (b) were born in the United States, (c) had a working telephone, and (d) lived in Minnesota, Ohio, or Utah. Multiple-cycle coding, Hatch’s 9-step approach, and constant comparative data analysis was employed for de-identified transcript data. Results Eighty-four African-American men met inclusion criteria and participated. Their mean age was 59.34 ± 7.43. In regards to CRC screening status, Ohio had the most previously screened participants (85%), followed by Minnesota (84%) and Utah (76%). Two major CRC screening barriers (masculine role norms and medical mistrust) – both encompassed 3–5 subthemes, and one major facilitator (normative support from family members or social networks) emerged. Conclusions Despite CRC screening’s life-saving potential, African-American men have had the lowest 5-year relative survival for more than 40 years. When developing interventions and health promotion programs aiming to eliminate the racial disparity in CRC outcomes, addressing both masculine role norms and medical mistrust barriers to CRC screening completion among African-American men is warranted.

Factors associated with participation in colorectal cancer screening: A population-based study of 7200 individuals.

This study aimed to evaluate how the knowledge and perception towards colorectal cancer (CRC) screening had been changed in a large population, and identified factors associated with its participation based on factors pertinent to the Health Belief Model (HBM). Data from 3600 screening participants and 3600 non-participants were collected through a telephone survey via simple random sampling of telephone numbers in a territory-wide directory from December 2016 to November 2018. Sociodemographic factors; the enabling factors of screening as well as the barriers of screening were collected. The changes in these factors were evaluated by Pearson's chi-square trend test. A logistic regression model was constructed to identify the association between the above factors and CRC screening participation. The knowledge level (67.9% to 85.4%, p<0.001), perceived severity of having CRC (37.7%-42.8%, p<0.01), perceived benefits of screening (54.9%-72.1%, p<0.001), and reductions in barriers (14.1%-5.1%, p<0.001) of CRC screening significantly improved among the non-users. Subjects with older age (adjusted odds ratio (AOR): 2.01, p<0.001), higher knowledge level of screening methods (AOR: 6.68, p<0.001), greater perceived severity (AOR: 2.04, p<0.001) and coverage of insurance (AOR: 1.22, p<0.01) were more likely to participate. In contrast, more affluent subjects (AOR: 0.69, p<0.001), female individuals (AOR: 0.63, p<0.001), higher level of perceived psychological (AOR: 0.54, p<0.001) and access barriers (AOR: 0.55, p<0.001) were associated with poorer participation. These findings demonstrated a substantial increase in the enabling factors of CRC screening, including knowledge, perceived severity and perceived benefits. The study also identified the target groups such as younger individuals, females and more affluent people among whom more intensive educational initiatives are needed to enhance their participation.

Colorectal Cancer Screening Barriers at Latino-Serving Federally Qualified Health Center

Colorectal Cancer Screening Barriers at Latino-Serving Federally Qualified Health Center

S0319 Facilitators and Barriers of Colorectal Cancer Screening in an Outpatient Clinic

INTRODUCTION: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths in the United States. Still, 1 in 3 adults aged 50 to 75 years have not been screened for colorectal cancer. METHODS: This retrospective cross-sectional study conducted between July 1, 2018 and June 30, 2019 examined 2,428 patients aged 50 to 75 years from the East Carolina University (ECU) Internal Medicine (IM) clinic to determine the barriers and facilitators to CRC screening in eastern North Carolina. Eligible adults were those who had a fecal occult blood test (FOBT) or fecal immunochemical test (FIT) in the past year, Cologuard in the past 3 years, flexible sigmoidoscopy/virtual colonoscopy in the past 5 years, or colonoscopy in the past 10 years. Data on patient socioeconomic status, comorbidities, and other determinants of health compliance were included as covariates. Data extracted included race, gender, marital status, family history of colorectal cancer, no-show rate, employment status, education, travel distance to clinic, hypertension, diabetes, congestive heart failure, end-stage renal disease, obstructive sleep apnea, COPD, provider training, and patient compliance with other health screenings. RESULTS: This study revealed that age (OR = 1.058; P = 0.017), no-show rate percent (OR = 0.962; P < 0.05), patient history of obstructive sleep apnea (OR = 1.875; P = 0.025), compliance with flu vaccinations (OR = 1.673; P < 0.05), compliance with screening mammograms (OR = 2.130; P < 0.05), and compliance with screening pap smears (OR = 2.708; P < 0.05) were important factors in determining whether a patient will receive CRC screening. Additionally, data on the type of CRC screening test performed was available for 1,618 patients who were up to date on their CRC screening. In this subset of patients, 92.82% indicated that their CRC screening was performed via colonoscopy, 2.97% were screened using Cologuard, 1.79% were screened using flexible sigmoidoscopy, 1.42% reported screening with FOBT, and 0.99% reported screening with CT Colonography. CONCLUSION: Our study revealed that the age of patient, history of sleep apnea, compliance with other health maintenance tests were significant facilitators to CRC screening, while no-show rate percent was a significant barrier in our patient population. This study will be of benefit to physicians as they consider barriers to patient adherence to CRC screening.Table 1.: Supplemental Information-Facilitator and Barriers of Colorectal cancer screening