Barriers to Colorectal Cancer Screening in Rural Appalachian Kentucky

Authors: Aroh A., Adegboyega A., Smalls B., Hatcher J.

Category: Cancer Health Disparities, Early Detection & Risk Prediction
Conference Year: 2018

Abstract Body:
Background: Appalachian Kentucky residents suffer significant colorectal cancer (CRC) disparity, in part related to low utilization of CRC screening. Reducing or removing potential barriers to CRC screening uptake may increase utilization of CRC screening in this population. The purpose of this study is to identify barriers to CRC screening in adults aged 50 years and older in rural Appalachian Kentucky. Methods: We report barriers to CRC screening based on baseline data collected during an emergency department (ED) placed intervention to reduce disproportionate burden of CRC among rural Appalachian Kentucky adults. Descriptive and bivariate analyses are reported. Results: Questionnaires were completed by 191 adults aged 50 and over, waiting for non- urgent care or with a family member in the ED of rural Appalachian hospitals. Participants were mostly Caucasian (98%), female (57%), aged 58 ± 8 years, who had household income < $20,000 (56%), and 95% had never undergone CRC screening. Fear of CRC result (51%), perceived pain (50%), and cost (49%) were the most salient barriers to CRC screening test. The following four demographic variables were significantly associated with barriers to CRC screening; education, marital status, income and age. Conclusions: Rural Appalachian Kentucky residents do not screen for CRC according to guidelines partly due to perceived barriers to CRC screening. This population will benefit from interventions that address barriers to screening and appropriate navigation to affordable and accessible CRC screening resources within the local community. In addition, considering the cultural norms peculiar to this population, the use of community health workers (CHW) and individuals who have undergone CRC screening may be valuable resources to design other interventions like short video messages to talk about the screening process and the benefits of CRC screening.

Keywords: colorectal cancer Rural Appalachian