期刊
SOUTHERN MEDICAL JOURNAL
卷 114, 期 5, 页码 293-298出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.14423/SMJ.0000000000001252
关键词
Appalachian; colorectal cancer; rural; screening; West Virginia
资金
- Pilot Project Grant from the Marshall University Robert C. Byrd Center for Rural Health
This study explores potential barriers to colorectal cancer (CRC) screening in the West Virginia Appalachian area. Through a cross-sectional survey, patient-reported barriers were identified using the health belief model to evaluate attitudes and behaviors. The discrepancies between the screened and unscreened groups mainly stem from perceptions of discomfort from screening tests, psychological and behavior deterrents in CRC screening and diagnosis, and limited resources for accessing care, especially transportation.
Objectives The age-appropriate colorectal cancer (CRC) screening rate in the rural Appalachian area is low compared with the national rate, which may account for the overall higher incidence of CRC in this area. The purpose of this study was to explore potential barriers to CRC screening in the West Virginia Appalachian area. Methods A cross-sectional survey was designed to identify patient-reported barriers to CRC screening using the health belief model to assess their attitudes and behaviors. Autonomous paper-based surveys were randomly handed to individuals older than 50 years at various locations, including healthcare and nonhealthcare facilities. All of the responses were then categorized into two groups: the screened group and the unscreened group. Differences among both groups were statistically analyzed. Results There were three main areas that significantly accounted for the discrepancies between the screened and unscreened groups: perceptions of discomfort from screening tests, psychological and behavior deterrents in CRC screening and diagnosis, and limited resources for accessing care, especially transportation. In particular, psychological and behavioral deterrents in CRC screening appeared to play a role in promoting aversion to CRC screening. Conclusions Lack of CRC screening awareness and knowledge may be responsible for fatalism regarding CRC and aversion to screening. Thus, multidisciplinary interventions that provide education about CRC screening, early intervention prognosis, and treatment options, as well as addressing systemic barriers to screening, such as assistance with scheduling, prep instructions, and transportation, can improve the screening rate in Appalachia and eventually lead to better outcomes through the early diagnosis of CRC.
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