BACKGROUND: Barriers to colorectal cancer (CRC) screening are not well understood. OBJECTIVES: We sought to compare barriers to CRC screening reported by primary care physicians (PCPs) and by average-risk adults, and to examine characteristics of average-risk adults who identified lack of provider recommendation as a major barrier to CRC screening. RESEARCH DESIGN: This was a comparative study using data from the 1999-2000 Survey of Colorectal Cancer Screening Practices and the 2000 National Health Interview Survey (NHIS). SUBJECTS: We recruited nationally representative samples of PCPs (n= 1235) from the SCCSP and average-risk adults (n = 6497) from the NHIS. MEASURES: We measured barriers to CRC screening identified by PCPs and average-risk adults who were not current with screening. RESULTS: Both PCPs and average-risk adults identified lack of patient awareness and physician recommendation as key barriers to obtaining CRC screening. PCPs also frequently cited patient embarrassment/anxiety about testing and test cost/lack of insurance coverage, but few adults identified these as major barriers. Of adults not current with testing, those who had visited a doctor in the past year or had health insurance were more likely to report lack of physician recommendation as the main reason they were not up-to-date compared with their counterparts with no doctor visit or health insurance. Only 10% of adults not current with testing and who had a doctor visit in the past year reported receiving a screening recommendation. CONCLUSIONS: A need exists for continued efforts to educate the public about CRC and the important role of screening in preventing this disease. Practice-based strategies to systematically prompt health care providers to discuss CRC screening with eligible patients also are required.
BACKGROUND: Barriers to colorectal cancer (CRC) screening are not well understood. OBJECTIVES: We sought to compare barriers to CRC screening reported by primary care physicians (PCPs) and by average-risk adults, and to examine characteristics of average-risk adults who identified lack of provider recommendation as a major barrier to CRC screening. RESEARCH DESIGN: This was a comparative study using data from the 1999-2000 Survey of Colorectal Cancer Screening Practices and the 2000 National Health Interview Survey (NHIS). SUBJECTS: We recruited nationally representative samples of PCPs (n= 1235) from the SCCSP and average-risk adults (n = 6497) from the NHIS. MEASURES: We measured barriers to CRC screening identified by PCPs and average-risk adults who were not current with screening. RESULTS: Both PCPs and average-risk adults identified lack of patient awareness and physician recommendation as key barriers to obtaining CRC screening. PCPs also frequently cited patient embarrassment/anxiety about testing and test cost/lack of insurance coverage, but few adults identified these as major barriers. Of adults not current with testing, those who had visited a doctor in the past year or had health insurance were more likely to report lack of physician recommendation as the main reason they were not up-to-date compared with their counterparts with no doctor visit or health insurance. Only 10% of adults not current with testing and who had a doctor visit in the past year reported receiving a screening recommendation. CONCLUSIONS: A need exists for continued efforts to educate the public about CRC and the important role of screening in preventing this disease. Practice-based strategies to systematically prompt health care providers to discuss CRC screening with eligible patients also are required.
Authors: Simone Dahrouge; William E Hogg; Grant Russell; Meltem Tuna; Robert Geneau; Laura K Muldoon; Elizabeth Kristjansson; John Fletcher Journal: CMAJ Date: 2011-12-05 Impact factor: 8.262
Authors: Chyke A Doubeni; Adeyinka O Laiyemo; Angela C Young; Carrie N Klabunde; George Reed; Terry S Field; Robert H Fletcher Journal: Ann Fam Med Date: 2010 Jul-Aug Impact factor: 5.166
Authors: Yelena N Tarasenko; Sarah B Wackerbarth; Margaret M Love; Jennifer M Joyce; Steven A Haist Journal: J Cancer Educ Date: 2011-06 Impact factor: 2.037