Understanding Barriers to Colorectal Cancer Screening in Kentucky
ORIGINAL RESEARCH — Volume 12 — June 18, 2015
The 19 reasons cited by respondents aged 50 years or older who answered no to a question assessing barriers to colorectal cancer screening, “Have you ever been screened for colorectal cancer by sigmoidoscopy or colonoscopy,” in the 2012 Kentucky Behavioral Risk Factor Surveillance System Survey were as follows: Attitudes and beliefs: Test not needed, has no symptoms of colorectal cancer, has no family history of the disease, does not want to have the test, has not thought about having the test, fears that the test is uncomfortable or painful, has no time to be tested, postponed having the test or is too lazy to have the test, test is embarrassing, afraid of what the test may find, too old to have the test, too young to have the test, test does not work, test is not effective. Health care provider and health care systems: Doctor did not recommend the test, doctor never said test was needed, no facilities or doctors nearby, inconvenient to travel required distance to a testing facility, does not know where to go for testing or how to go about getting tested. Cost: Cost of the test, test not covered by insurance, has no transportation or difficulty finding transportation, has no regular doctor, does not go to the doctor. Other: Does not know or is not sure, other.
Figure 1. Nineteen reasons cited by respondents aged 50 years or older who answered no to question assessing barriers to colorectal cancer screening: “Have you ever been screened for colorectal cancer by sigmoidoscopy or colonoscopy,” in the 2012 Kentucky Behavioral Risk Factor Surveillance System Survey.
Population taking the Kentucky Behavioral Risk Factor Surveillance System Survey in 2012 (N = 11,223); Respondents aged 50 years or older (N = 7,077). Question asked: Sigmoidoscopy and colonoscopy are examinations in which a tube is inserted in the rectum to view the colon and rectum for signs of cancer or other health problems. Have you ever had either of these exams? Answers: Yes, N = 4,673; No, N = 2,263 or don’t know or not sure, N = 141. The following Kentucky state-added question was asked of the total 2,283 who responded no or don’t know or not sure: “What is the most important reason you have never had a sigmoidoscopy or colonoscopy?” Nineteen possible answers were combined into 4 categories: attitudes and beliefs, health care provider and health care systems barriers, cost, other.
Figure 2. Paradigm used to identify Kentuckians aged 50 years or older never screened for colorectal cancer via colonoscopy or sigmoidoscopy, from survey question about barriers to colorectal cancer screening in 2012 Kentucky Behavioral Risk Factor Surveillance System.
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