Low CRC screening rates can be attributed to multiple reported barriers at the patient, provider, and healthcare system levels.1-3 Often these barriers are perceived differently among patients and providers.1,2
The number one barrier to CRC screening reported by unscreened patients was lack of a provider recommendation/referral.1 In a separate study, providers perceived that the primary barriers were at the patient level2
Follow-up with colonoscopy after positive stool based CRC screening results is required for screening benefits to be achieved3
DIFFERENCE IN PATIENT REPORTED BARRIERS BY CRC SREENING STATUS (N=198)1,a
- The number one barrier reported by unscreened patients was no recommendation/referral by a healthcare provider, followed by fear and finances1
- Among screened patients, fear and logistics were cited as the major barriers1
CLINICIAN-PERCEIVED BARRIERS TO CRC SCREENING (N=93)2,d
- Clinicians perceived that the number one provider barrier was lack of time to discuss screening2
- Clinicians perceived that the main system barriers were lack of a reminder system and lack of support staff2
- Clinicians were asked about their perceived patient barriers - they reported fear, finances, other health issues, lack of awareness, health literacy, and a fatalistic attitude toward cancer as the most common barriers2
References
1 Muthukrishnan M, Arnold LD, James AS. Patients’ self-reported barriers to colon cancer screening in federally qualified health center settings. Prev Med Rep. 2019;15:100896.
2 Wang H, Gregg A Qiu F, et al. Provider perceived colorectal cancer screening barriers: results from a survey of accountable care organizations. JOJ Public Health. 2017;1(2):555557.
3 Davidson KW, Barry MJ, Mangione CM, et al. Screening for colorectal cancer: US Preventive Services Take Force recommendation statement. JAMA. 2021;325(19):1965-1977.
Footnotes
a Cluster-randomized trial performed in 11 urban and rural safety-net primary care sites across two health systems aimed at evaluation of self-identified barriers to colorectal cancer screening (n=483). Data were collected through surveys administered in person, by phone or mail. Previously screened and unscreened participants (age ≥50) were asked about health insurance and access to care, and “What barriers/things got in the way of being screened?”
b Fear related to CRC screening manifested in different ways, with patients expressing concerns related to the procedure, sedation, and outcomes of the procedure.
c Other barriers include medical mistrust (n=4), lack of information on CRC screening (n=5), religious reasons (n=2), or they simply “don’t want to” (n=7).
d Survey-based study of 93 primary care providers from 13 Accountable Care Organization clinics, primarily in rural communities.
Last updated: 3/31/2023