Racial disparities and barriers to colorectal cancer screening in rural areas

J Am Board Fam Med. 2012 May-Jun;25(3):308-17. doi: 10.3122/jabfm.2012.03.100307.

Abstract

Introduction: This study examined barriers to colorectal cancer (CRC) screening in people living in rural areas.

Methods: We identified 2 rural counties with high rates of CRC and randomly contacted county residents by telephone using a published listing.

Results: Six hundred thirty-five of the 1839 eligible respondents (34.5%) between the ages of 50 and 79 years living in McDuffie and Screven counties, Georgia, agreed to complete the survey. The mean age was 62.2 years (SD, ±7.5 years); 72.4% were women, 79.4% were white, and 19.5% were African American. African-American respondents had lower CRC screening rates (50.4%) than whites (63.4%; P = .009). Significantly more African Americans compared with whites reported barriers to CRC screening. Based on logistic regression analyses, having a physician recommend CRC screening had the strongest association with having a current CRC screening, regardless of race.

Conclusions: Important racial differences existed between African Americans and whites regarding the barriers to CRC screening and factors impacting current screening. However, endorsement of a small set of questionnaire items--not race--had the strongest association with being current with screening. Physician recommendation for CRC screening had the strongest association with being current with CRC screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Black or African American / statistics & numerical data
  • Chi-Square Distribution
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / epidemiology
  • Early Detection of Cancer / methods
  • Female
  • Georgia / epidemiology
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility*
  • Health Services Needs and Demand*
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Minority Health
  • Odds Ratio
  • Perception
  • Prejudice
  • ROC Curve
  • Racial Groups / statistics & numerical data*
  • Rural Population / statistics & numerical data*
  • Self Report
  • Statistics as Topic
  • Survivors
  • White People / statistics & numerical data