Journal of Community Health

, Volume 38, Issue 2, pp 285–292

Self-Reported Barriers to Colorectal Cancer Screening in a Racially Diverse, Low-Income Study Population

  • Benjamin W. Quick
  • Christina M. Hester
  • Kristin L. Young
  • K. Allen Greiner
Original Paper


Colorectal cancer (CRC) screening is underutilized, especially in low income, high minority populations. We examined the effect test-specific barriers have on colonoscopy and fecal immunochemical test (FIT) completion, what rationales are given for non-completion, and what “switch” patterns exist when participants are allowed to switch from one test to another. Low income adults who were not up-to-date with CRC screening guidelines were recruited from safety-net clinics and offered colonoscopy or FIT (n = 418). Follow up telephone surveys assessed test-specific 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 non-completers than completers (p = 0.001 and p < 0.001, 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 non-completers than completers (p = 0.003, p = 0.006, and p < 0.001, 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 test-specific barriers apply more to subjects who did not complete CRC screening. As a common rationale for test non-completion 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 made.


Colorectal cancer screening Barriers FIT Colonoscopy Test preference 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Benjamin W. Quick
    • 1
  • Christina M. Hester
    • 1
  • Kristin L. Young
    • 1
    • 2
  • K. Allen Greiner
    • 1
  1. 1.Research Division, Department of Family MedicineUniversity of Kansas Medical CenterKansas CityUSA
  2. 2.Department of Epidemiology, Carolina Population CenterUniversity of North CarolinaChapel HillUSA

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