Abstract 7096: Barriers and intention to screen for colorectal cancer among non-adherent women in Puerto Rico: an assessment from the Puerto Rico Community Engagement Alliance (PR-CEAL)
Authors: Karelys I. Canales-Birriel, Cynthia M. Pérez, Norangelys Solís-Torres, Nashaly M. Saldaña-Santiago, Alondra K. Mercado-Andino, Christian Rivera-Catala, Cecilia Marino-Nieto, Héctor Contreras-Mora, Vivian Colón-López
Journal: Cancer Research (2025)

Abstract Background: Colorectal cancer (CRC) ranks among the top three most diagnosed cancers in men (11.1%) and women (9.5%) in Puerto Rico (PR). Despite efforts to promote early detection, screening rates remain suboptimal, likely due to cultural beliefs, socioeconomic disparities, and limited healthcare access. Objectives: This study assessed the barriers and intentions for screening among Hispanic women in PR who are non-adherent to FOBT and colonoscopy guidelines. Methods: PR-CEAL conducted a community based participatory research across various community settings in PR from December 2023 to June 2024, targeting women aged 45-75 who were non-adherent to CRC screening according to the USPSTF guidelines. Eligible women completed an in-person baseline survey where participants provided information about barriers they faced regarding screening and their intentions to screen. To encourage adherence to CRC screening recommendations, community health workers (CHWs) distributed educational materials aligned with USPSTF guidelines. Log-binomial regression models assessed the associations between test modality, barriers, and readiness for screening; how ready do you feel to schedule an appointment to get tested? controlling for age and health insurance. Results: Enrolled women had a median age of 59, 31.2% held a bachelor’s degree or higher, 64.9% earned $15, 000 or less, 68.2% had public health insurance, and 43.4% married or cohabitating. Readiness for CRC screening differed by test modality (p &amp;lt; 0.001), with the highest readiness observed among women in the FOBT group (95.2%, n=118), followed by the colonoscopy group (71.2%, n=84) and the dual modality group (71.4%, n=110). Log-binomial models showed that women in colonoscopy group and women in dual modality group were less likely to be ready for screening compared to FOBT group (RR=0.76, 95% CI: 0.67-0.85; RR=0.74, 95% CI: 0.67-0.83; respectively). Key barriers to CRC screening included the lack of physician recommendation (50.0%, n=198) and being too busy (18.7%, n=74). Women in the dual modality group were more likely than those in FOBT group to report barriers such as not having symptoms (RR=2.15, 95% CI: 1.14-4.04) and being too busy to undergo screening (RR=1.81, 95% CI: 1.07-3.06). Conclusions: Findings show varying readiness and barriers for CRC screening by test modality. Women in FOBT group demonstrated higher readiness, highlighting the importance of non-invasive tests in promoting screening. Tailored interventions using CHW should address barriers while highlighting the benefits of screening for asymptomatic individuals. Strategies to improve readiness could include enhancing patient education, increasing awareness of screening, and emphasizing the simplicity and accessibility of FOBT. Citation Format: Karelys I. Canales-Birriel, Cynthia M. Pérez, Norangelys Solís-Torres, Nashaly M. Saldaña-Santiago, Alondra K. Mercado-Andino, Christian Rivera-Catala, Cecilia Marino-Nieto, Héctor Contreras-Mora, Vivian Colón-López. Barriers and intention to screen for colorectal cancer among non-adherent women in Puerto Rico: an assessment from the Puerto Rico Community Engagement Alliance (PR-CEAL) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7096.