P0268 - Elucidating the Barriers to Cancer Screening in a Rural Population: A Quality Improvement Project

Tarek Mansi, MD¹, Nooraldin Merza, MD², Sameer Prakash, DO³, Izi Obokhare, MD^1
1Texas Tech University Health Sciences Center, Amarillo, TX; ²Wayne State University, Dearborn, MI; ³University of Iowa, Iowa City, IA

Introduction: Only 67.4% of US adults aged indicated patients were up to date on colorectal cancer (CRC) screening in 2016, with persistent disparities based on income, education, race/ethnicity, language, and insurance coverage. The heavy reliance on colonoscopy for screening in populations facing these obstacles may contribute to the existing disparities, which may be remediated by expanded use of more straightforward and more cost-effective screening tools.

Methods: Multiple surveys were distributed at various cancer screening events. Eligible patients were asked to fill our questionnaire designed and prepared in Texas Tech University health care system in Amarillo, Texas, serving suburban and surrounding rural communities. The single-page questioner was to target the screening barriers to cancer. The single question was focused on the question: "What barriers do you experience with cancer screening? Please mark all that apply:" The questionnaire included patients’ age, sex, and race. Barriers to cancer screening were Embarrassment, Unpleasantness of test, transportation, cost/lack of insurance, Fear of results, Lack of symptoms, Lack of physician recommendations, Lack of awareness, Language barriers, and other causes.

Results: A total of 194 patients responded to our survey. 62.9% (122) females, 36.6 % (71) males, and one patient did not specify. These genders were generally equally represented among all races. The age ranged from 13 to 86 years with a mean of 51.79 and standard deviation of 13.5. The overwhelmingly main barrier for screening was lack of funding or insurance (66%). Other reasons were Lack of awareness (37%), Lack of symptoms (34%), and fear of the test (26%), followed by less frequent answers.



Discussion: A combination of patient, clinician, and staff education and focused patient follow-up in a resident-led, all required for creating a comprehensive approach improving CRC screening rates across clinics with lower screening rates at baseline and a high proportion of uninsured patients. Although this project was a small step, it was helpful to examine the main screening barriers specifically in our community, which were the insurance and the awareness, which enabled us to do the subsequent project-oriented about spreading awareness and using fecal immunochemical tests as a first step toward increasing CRC screening in underserved patient populations.


Figure: Different barriers to cancer screening


Disclosures:
Tarek Mansi indicated no relevant financial relationships.
Nooraldin Merza indicated no relevant financial relationships.
Sameer Prakash indicated no relevant financial relationships.
Izi Obokhare indicated no relevant financial relationships.


Tarek Mansi, MD¹, Nooraldin Merza, MD², Sameer Prakash, DO³, Izi Obokhare, MD¹. P0268 - Elucidating the Barriers to Cancer Screening in a Rural Population: A Quality Improvement Project, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.