EP287 - Under-screened and Underserved: A qualitative study exploring the barriers to colorectal cancer screening of an underserved population

Purpose/Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, with black men experiencing higher incidences and mortality rates compared to other racial groups. Despite this, black men have lower rates of CRC screening compared to white men, white women and black women. In our local community, we hypothesized that the greatest barrier to CRC screening in black men was financial in nature, specifically cost of materials for bowel preparation and transportation. This study aimed to determine what the barriers were for CRC screening in our local black male community through listening and education sessions followed by a questionnaire at men's groups at two local churches.

Methods/Interventions: We conducted two separate listening sessions at men's small groups at two local churches with predominantly black members. These were round table discussions facilitated by our institution's community outreach coordinator and black leaders of the churches. Education about CRC and screening was given by a colorectal surgeon of color. The men asked questions and made comments about CRC and CRC screening. We discussed barriers preventing them from getting screened. A post-discussion questionnaire was given after both the sessions. A qualitative analysis was done to extrapolate the main barriers to CRC screening in this population.

Results/Outcomes: Themes were extrapolated from our discussion sessions and the questionnaires, see table one and two. At both sessions, black leaders at the churches mentioned the importance of themselves being responsible for educating the younger generation on the importance of CRC screening. Barriers to CRC screening extrapolated: insurance issues, expensive co-pays, bowel preparation concerns, concerns of feeling violated, mistrust in screenings, fear of bad news and transportation difficulties.

Conclusion/Discussion: While cost is a barrier to screening black men for CRC, culture, mistrust of medical professionals and lack of knowledge are also barriers. With continued partnerships with local community leaders, we can improve the health of our entire community and break down barriers to black male community health. Continued outreach is important as we glean much more information from personal discussions rather than questionnaires. Future directions include sessions with younger generations in culturally appropriate spaces like barbershops.

Table 1.
Themes extrapolated from discussion sessions
Table 2.
Questionnaire questions and answers