Barriers Driving Racial Disparities in Colorectal Cancer Screening in African Americans

Curr Gastroenterol Rep. 2020 Jul 9;22(8):41. doi: 10.1007/s11894-020-00776-0.


Purpose of review: Colorectal cancer screening has been shown to decrease mortality from colorectal cancer. Screening disparities continue to exist among ethnic minorities, particularly for African Americans. We herein review the barriers of colorectal cancer screening in this population.

Recent findings: At its foundation are patient barriers, which are further compounded by physician-related barriers and the idiosyncrasies of the healthcare system. Interventions to address the barriers include patient outreach, provider education, and healthcare legislation addressing financial barriers. Recent research has focused on factors predicting intentions to undergo colorectal cancer screening. Underlying all of the barriers is the systemic racism that affects and influences the healthcare system as much as all other institutions and contributes to inequities in the delivery of effective cancer prevention efforts. Perpetual disparities in CRC screening within the African American community are due to multifactorial barriers from the individual patient to provider and healthcare system and societal influences. An awareness of the behavioral and systemic factors that affect African Americans must underpin efforts to reach full equity in delivering CRC screening to this often medically underserved segment of our society.

Keywords: African Americans; Barriers; Colorectal cancer; Disparities; Screening.

Publication types

  • Review

MeSH terms

  • Black or African American*
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / ethnology
  • Colorectal Neoplasms / mortality
  • Early Detection of Cancer / standards*
  • Health Services Accessibility*
  • Healthcare Disparities* / ethnology
  • Humans
  • Mass Screening / standards
  • Racism* / ethnology