Colorectal cancer screening among underserved minority population: discrepancy between physicians' recommended, scheduled, and completed tests

Patient Educ Couns. 2009 Aug;76(2):240-7. doi: 10.1016/j.pec.2008.12.005. Epub 2009 Jan 15.


Objective: This study examines the correlates of: (1) health care provider recommendation of CRC testing; (2) provider scheduling for recommended CRC testing using sigmoidoscopy, colonoscopy, or double-contrast barium enema; and (3) adherence to CRC scheduling among underserved minority populations.

Methods: Medical record and schedule logbook reviews and interviewer-administered surveys.

Setting: Large urban safety-net, outpatient primary care setting in Los Angeles County.

Participants: 306 African-American and Latino patients aged 50 years and older.

Results: A vast majority of minority patients do not receive standard CRC testing in urban safety-net primary care settings. Of those patients who were actually scheduled for sigmoidoscopy or colonoscopy, almost half completed the procedure. Completing CRC testing was associated with marital status, co-morbid chronic physical conditions, number of risk factors for colorectal cancer, and lower perceived barriers to CRC testing.

Conclusion: Effective interventions to reduce CRC mortality among underserved minority populations require an integrated approach that engages patients, providers, and health care systems.

Practice implications: Designing interventions that (1) increase physician-patient communications for removing patients' perceived barriers for CRC testing and (2) promote a non-physician-based navigator system that reinforces physicians' recommendation are strongly recommended.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans / statistics & numerical data
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Appointments and Schedules
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / prevention & control
  • Communication
  • Confidence Intervals
  • Female
  • Health Care Surveys
  • Health Status Disparities*
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Mass Screening / statistics & numerical data*
  • Medically Underserved Area*
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • Multivariate Analysis
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Education as Topic / statistics & numerical data*
  • Physician-Patient Relations
  • Prospective Studies
  • Statistics as Topic
  • United States