Abstract PO-058: Barriers and facilitators to colorectal cancer screening: A Utah community- based study
Authors: Pauleck Svenja , Hardikar Sheetal , Esplin Jordan , Pahlkotter Maranda , Williamson Andrea , Brecha Federica S. , Harding Garrett , Ferre Nathaniel , Ortiz Nancy , Marcus Robin , Lewis Mark , Cohen Jessica 
Published: December 2020

There are disparities in colorectal cancer screening related to variations in patient- level factors including race, ethnicity, geography, and language. We conducted a survey among a diverse sample of adults eligible for colorectal cancer screening at three community health events in Salt Lake City, Utah to identify barriers and facilitators to screening. We report descriptive statistics and results of chi-squared testing to identify factors associated with the receipt of colorectal cancer screening. Of the 117 respondents, 37% were Caucasian, 17% African-American, 11% Asian, 3% American-Indian, and 1% Native Hawaiian/ Pacific Islander; 33% identified as Hispanic or Latino/a. Twenty-four percent of the study participants completed surveys in Spanish, the remainder in English. Half (50%) of the responders were ≤55 years, 37% were 56-69 years and 13% were ≥ 70 years. A majority (76%) attended college and 20% completed high school or less. Over half (51%) were employed at the time of the survey and 75% reported having health insurance. Sixty percent previously underwent colorectal cancer screening, most commonly with colonoscopy (57%) or a stool-based test (13%). Most patients (70%) reported that the number one reason they were screened was due to a physician recommendation. Screened patients reported that their preferred colorectal cancer screening test was colonoscopy (40%) or a stool-based test (24%). Forty percent of respondents did not undergo any kind of colorectal cancer screening. This was significantly associated with Spanish speaking (p=0.02) and lack of health insurance (p&lt;0.01). We explored barriers to screening among those without colorectal cancer screening. With regards to stool-based testing, the most common barrier (23%) was not understanding how to do a test at home. Others were worried about handling their stool (15%), receiving a positive result (15%), or the cost of the test (15%). With regards to colonoscopy, the most common barriers were the bowel preparation (36%) and worry about discomfort or pain during the procedure (34%). The “not screened” group preferred screening by stool-based tests (49%). In conclusion, we found that among a racial, ethnic, educational, and economically diverse population of health event attendees, a substantial proportion did not receive colorectal cancer screening. These results indicate that there is a significant potential for improved screening in our community, particularly among the Spanish-speaking and uninsured populations. Future studies should evaluate cultural and language concordant interventions that can address identified barriers while promoting the observed facilitators.

Citation Format: Svenja Pauleck, Sheetal Hardikar, Jordan Esplin, Maranda Pahlkotter, Andrea Williamson, Federica S. Brecha, Garrett Harding, Nathaniel Ferre, Nancy Ortiz, Robin Marcus, Mark Lewis, Jessica Cohen. Barriers and facilitators to colorectal cancer screening: A Utah community- based study [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-058.