A qualitative examination of colorectal cancer screening utilization in an urban population
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Colorectal cancer continues to rank as one the leading causes of cancer death in the United States on an annual basis. The majority of deaths are preventable through routine screening, beginning at the age of 50, as outlined and recommended in widely published clinical practice guidelines. The purpose of this research endeavor was to qualitatively examine how individuals over the age 50 perceive colorectal cancer and its causes, the individual, social, systemic, and environmental level obstacles faced when considering and attempting colorectal cancer screening as well as the communication strategies they employed or deemed appropriate toward utilizing screening options. Using in-depth one-on-one interviews, data was collected from 20 individuals 50 years or older living in the greater metropolitan Atlanta, GA area. Participants, a number of whom have medical background, reported knowledge of some known and widely reported risk factors for colorectal cancer. Family history and dietary habits were the most reported risk factors, followed by some mention of alcohol and tobacco consumption. Participants also communicated an awareness and knowledge of colonoscopy and fecal occult blood test (FOBTs) as colorectal cancer screening options. Regarding communication with healthcare providers, participants emphasized patient accountability in preparing for their encounter with their personal healthcare providers, particularly about colorectal cancer screening. Participants engaging in screening were driven to do so by a perceived positive physician-patient interaction where the patient feels respected, feels the physician acts as an advocate, and where the physician engages the patient in informed and shared decision making about screening options. Finally, participants’ intention to act as defined by adherence to screening recommendation is further driven by the desire to avoid the experiences of family and friends who were diagnosed at a late stage with colorectal cancer. The findings from this study have implications for healthcare providers and researchers developing and implementing health interventions targeting men and women eligible for colorectal cancer screening.