Racial Disparities and Barriers to Colorectal Cancer Screening in Rural Areas

Introduction: This study examined barriers to colorectal cancer (CRC) screening in people living in rural areas. Methods: We identified 2 rural counties with high rates of CRC and randomly contacted county residents by telephone using a published listing. Results: Six hundred thirty-five of the 1839 eligible respondents (34.5%) between the ages of 50 and 79 years living in McDuffie and Screven counties, Georgia, agreed to complete the survey. The mean age was 62.2 years (SD, +/- 7.5 years); 72.4% were women, 79.4% were white, and 19.5% were African American. African-American respondents had lower CRC screening rates (50.4%) than whites (63.4%; P = .009). Significantly more African Americans compared with whites reported barriers to CRC screening. Based on logistic regression analyses, having a physician recommend CRC screening had the strongest association with having a current CRC screening, regardless of race. Conclusions: Important racial differences existed between African Americans and whites regarding the barriers to CRC screening and factors impacting current screening. However, endorsement of a small set of questionnaire items-not race-had the strongest association with being current with screening. Physician recommendation for CRC screening had the strongest association with being current with CRC screening. (J Am Board Fam Med 2012;25:308-317.)