TY - JOUR
T1 - Determinants of Variations in Self-reported Barriers to Colonoscopy Among Uninsured Patients in a Primary Care Setting
AU - Ojinnaka, Chinedum
AU - Vuong, Ann
AU - Helduser, Janet
AU - Nash, Philip
AU - Ory, Marcia G.
AU - McClellan, David A.
AU - Bolin, Jane N.
PY - 2015/4
Y1 - 2015/4
N2 - Colorectal cancer (CRC) is the third most common type of cancer among both males and females in the United States and the second leading cause of cancer-related deaths. Although largely preventable through screening, early detection and removal of polyps, screening rates are considered sub-optimal. Perceived barriers to screening have been reported to influence screening rates. This paper examines variations in the extent to which uninsured patients identified barriers to CRC screening using colonoscopy based on race/ethnicity, educational attainment, age, gender, marital status and prior colonoscopy. Multivariate analyses showed that compared to Caucasians, African Americans had an increased likelihood of identifying lack of transportation as a barrier [odds ratio (OR) 2.68; 95 % confidence interval (CI) 1.35–5.32] while Hispanics were more likely to identify fear of finding cancer as a barrier (OR 2.09; 95 % CI 1.19–3.66). Compared to those with more than a high school education, there was increased likelihood of identifying lack of knowledge as a barrier among individuals with high school education (OR 3.51; 95 % CI 1.94–6.36) or less than a high school education (OR 2.16; 95 % CI 1.04–4.50). Our findings suggest that strategies aimed at increasing colonoscopy screening rates among underserved populations should take into consideration race/ethnicity, educational attainment, age, and prior colonoscopy experience when developing education and outreach plans to reduce barriers to colonoscopy.
AB - Colorectal cancer (CRC) is the third most common type of cancer among both males and females in the United States and the second leading cause of cancer-related deaths. Although largely preventable through screening, early detection and removal of polyps, screening rates are considered sub-optimal. Perceived barriers to screening have been reported to influence screening rates. This paper examines variations in the extent to which uninsured patients identified barriers to CRC screening using colonoscopy based on race/ethnicity, educational attainment, age, gender, marital status and prior colonoscopy. Multivariate analyses showed that compared to Caucasians, African Americans had an increased likelihood of identifying lack of transportation as a barrier [odds ratio (OR) 2.68; 95 % confidence interval (CI) 1.35–5.32] while Hispanics were more likely to identify fear of finding cancer as a barrier (OR 2.09; 95 % CI 1.19–3.66). Compared to those with more than a high school education, there was increased likelihood of identifying lack of knowledge as a barrier among individuals with high school education (OR 3.51; 95 % CI 1.94–6.36) or less than a high school education (OR 2.16; 95 % CI 1.04–4.50). Our findings suggest that strategies aimed at increasing colonoscopy screening rates among underserved populations should take into consideration race/ethnicity, educational attainment, age, and prior colonoscopy experience when developing education and outreach plans to reduce barriers to colonoscopy.
KW - Barriers
KW - Colorectal cancer
KW - Determinants
KW - Uninsured
KW - Variations
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U2 - 10.1007/s10900-014-9925-8
DO - 10.1007/s10900-014-9925-8
M3 - Article
C2 - 25096763
AN - SCOPUS:84939892471
VL - 40
SP - 260
EP - 270
JO - Journal of Community Health
JF - Journal of Community Health
SN - 0094-5145
IS - 2
ER -