SelfReported Barriers to Colorectal Cancer Screen

Authors: Benjamin W Quick Christina M Hester Kristin L Young K Allen Greiner

Publish Date: 2012/09/14

Volume: 38, Issue: 2, Pages: 285-292

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Abstract

Colorectal cancer CRC screening is underutilized especially in low income high minority populations We examined the effect testspecific barriers have on colonoscopy and fecal immunochemical test FIT completion what rationales are given for noncompletion and what “switch” patterns exist when participants are allowed to switch from one test to another Low income adults who were not uptodate with CRC screening guidelines were recruited from safetynet clinics and offered colonoscopy or FIT n = 418 Follow up telephone surveys assessed testspecific barriers Test completion was determined from patient medical records For subjects who desired colonoscopy at baseline finding a time to come in and transportation applied more to noncompleters than completers p = 0001 and p  0001 respectively For participants who initially wanted FIT keeping track of cards never putting stool on cards and not remembering to mail cards back applied more to noncompleters than completers p = 0003 p = 0006 and p  0001 respectively The most common rationale given for not completing screening was a desire for the other screening modality 7  of patients who initially preferred screening by FIT completed colonoscopy while 8  of patients who initially preferred screening by colonoscopy completed FIT We conclude that testspecific barriers apply more to subjects who did not complete CRC screening As a common rationale for test noncompletion is a desire to receive a different screening modality our findings suggest screening rates could be increased by giving patients the opportunity to switch tests after an initial choice is madeThis study was made possible by a partnership with the Wyandotte County Kansas City Kansas Safety Net Clinic Coalition The study was supported by laboratory services from Enterix Inc a Division of Quest Diagnostics Inc Lenexa Kansas We would also like to thank study staff in the KUMC Family Medicine Research Division particularly Angela Watson Aaron Epp Marina CarizosaRamos Megan Eckles Heraclio Perez and Andrew Witt We are grateful to HungWen Yeh PhD of the KUMC Department of Biostatistics for providing assistance with the statistical analysis This project was supported by research funding from the National Cancer Institute R01 CA12324502

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