Beliefs, Risk Perceptions, and Gaps in Knowledge as Barriers to Colorectal Cancer Screening in Older Adults

Abstract

Lack of knowledge and awareness and the absence of a physician's recommendation to be tested might explain not being up to date with CRC screening in adults in these age groups. These findings suggest a potential value for better communication between older adults and their providers regarding screening for CRC, when appropriate.

Participation and Barriers to Colorectal Cancer Screening in Malaysia

“…In a study by Berkowitz et al (2008), more than three quarter of their samples said that their health care provider did not recommend for screening. Another study also showed that lack of physician recommendation is one of the main barriers for screening (Seeff et al, 2004).…”

Knowledge and perception toward colorectal cancer screening in east of Iran

“…This data is far from the current situation in the US where about 65% of people aged 50 or older have received CRC screening test consistent with current guidelines and it is still below target rates (30). Like other studies, age, has been found as an important factor in the knowledge of people with rates higher among older individuals, which can be due to increased risk of comorbidities in older people that force them to seek medical advice more than the others, although this must be evaluated in further studies with emphasizing on relationship between co-morbidities and CRC screening rate (15,16,31). One of the most important barriers to CRC screening in our population is limited literacy that deprives them of general or particular awareness and information.…”

“…According to American Cancer Society, the US Multi-Society Task Force on CRC and the American College of Radiology guidelines, screening of adenomatous polyps and CRC in average-risk adults should begin at age 50 years with one of the following options: 1) annual guaiac Fecal Occult Blood Test (gFOBT) or Fecal Immunochemical Test (FIT) or testing stool for exfoliated cell DNA, 2) flexible sigmoidoscopy every 5 years; 3) colonoscopy every 10 years, 4) double-contrast barium enema every 5 years, or 5) CT colonography every 5 years (7-10). Previously, several published researches from various countries with different races and cultures have reported patient barriers to CRC screening as health illiteracy and lack of knowledge, negative attitudes about prevention and cancer, financial concerns and lack of physician's recommendation for screening tests (2,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Also, in a study by Beydoun and Beydoun in US, predictors of CRC screening behaviors among average-risk older adults included older age, male gender, marriage, higher education, higher income, white race, non-Hispanic ethnicity, smoking history, presence of chronic diseases, family history of CRC, usual source of care, physician recommendation, utilization of other preventive health services, and health insurance coverage (26).…”

Equity of colorectal cancer screening: which groups have inequitable participation and what can we do about it?

“…In the general population, the main cited barriers to CRC screening are lack of knowledge (Berkowitz, Hawkins, Peipins, White, & Nadel, 2007), lack of trust in doctors (Lasser, Ayanian, Fletcher, & DelVicchio Good, 2008), lack of doctors' recommendation (Wardle et al, 2004), fatalistic views about cancer (Lasser et al, 2008), procrastination (Worthley, Cole, Esterman, Mehaffey, Roosa, Smith et al, 2006) and embarrassment (Rossi, Federici, Bartolozzi, Farchi, Borgia, & Guasticchi, 2005).…”