Abstract B100: Reported barriers to colorectal cancer screening in Appalachian Kentucky
Authors: Aroh Adaeze , Adegboyega Adebola , Hatcher Jennifer 
Published: August 2020

Abstract
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 was to identify barriers to CRC screening in adults aged 50 years and older in rural Appalachian Kentucky.
Methods: This study reports the analysis of baseline data from a randomized controlled trial designed to promote CRC screening in rural Appalachian Kentucky among individuals who have not been screened for CRC recruited from two Emergency Departments at St. Claire Regional Medical Center in Morehead, Kentucky, and Appalachian Regional Healthcare in Hazard, Kentucky. The survey used for this study assessed CRC screening status, barriers, susceptibility, and benefits related to CRC screening, sociodemographic characteristics, and other health-related information such as health care utilization including the reason for ED visit, insurance coverage, and health care access. Descriptive and bivariate analyses are reported.
Results: Questionnaires were completed by 191 adults aged 50 and over, waiting for nonurgent 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 &lt; $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. Education and income level were associated with the perception of painful and costly CRC screening in this population, suggesting that they do not have adequate knowledge or access to CRC screening resources available in the communities. Considering the cultural norms peculiar to Appalachian Kentucky, this population will benefit from a community health worker-led educational intervention to promote CRC screening through short video messages about the CRC screening process, other less invasive screening options, and benefits of CRC screening. This intervention may be able to address the barriers identified in this group, including the perception of painful screening procedure and the fear of screening result. Additionally, appropriate navigation program to affordable and accessible CRC screening resources within the local community would be beneficial to addressing the dismal use of screening resources among individuals in this population.
Citation Format: Adaeze Aroh, Adebola Adegboyega, Jennifer Hatcher. Reported barriers to colorectal cancer screening in Appalachian Kentucky [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B100.