Principal Investigator: Jessica Cohan
Keywords: Colorectal cancer screening Department: General Surgery Faculty
IRB Number: 00123254
Specialty: Surgery, General
Sub Specialties: Colorectal Surgery
Recruitment Status: Not yet recruiting

Contact Information

Jordan Esplin

Brief Summary

Hypothesis: Utahns face a number of barriers to obtaining colorectal cancer screening including lack of awareness, negative views of cancer, negative attitudes toward colorectal cancer screening tests, lack of motivation, and cultural, gender, and economic barriers. 

Specific aim 1a: Estimate guideline concordant colorectal cancer screening rates among university of utah patients and identify patient-reported barriers to screening using a survey distributed to University of Utah patients identified by EDW. 

Specific aim 1b: Estimate guideline concordant colorectal cancer screening rates among patients at health fairs and identify patient-reported barriers to screening using a survey distributed to patients at health fairs. 

Specific aim 2: Identify provider-reported barriers to colorectal cancer screening using interviews with stakeholders.

Detailed Description

Colorectal cancer is the second leading cause of cancer-related deaths in Utah.  Colorectal cancer screening has been definitively shown to decrease the incidence of colorectal cancer and deaths related to colorectal cancer.  However, Utah is plagued by poor adherence to colorectal cancer screening.  In data available from the Utah Department of Health Environmental Public Health Tracking data portal for 20161, only 72% of Utahns had undergone guideline appropriate colorectal cancer screening. Increasing the colorectal cancer (CRC) screening rates among socioeconomically, racially and ethnically diverse populations is a national priority. Though the Utah colorectal cancer screening rates have mirrored the US national data in recent years, not all Utahns are benefitting equally with significant disparities still prevalent. Although, the proportion of 50-75 year old Utahns adherent with colorectal cancer screening recommendations has risen from 48.0% in 2000 to 71.0% in 2014, significant disparities still exist. Only 50% Hispanics are guideline-adherent for colorectal cancer screening as compared to 75% non-Hispanics.1 Those that belong to a lower social-economic status are more likely to not have undergone colorectal cancer screening (57% CRC screening rate in those with total income <$25,000 vs 77% screening rate in income >$75,000).1 Furthermore, education is an important determinant such that rates were 80% among those with a college degree and <50% in those with a less than high school education.1 Utahns living in frontier and medically underserved areas have lowest rates of colorectal cancer screening. Moreover, there is no state-level data available on screening disparities by comorbidities that predispose to colorectal cancer development, including obesity and diabetes.We plan to 1a) estimate state-wide rates for guideline-concordant colorectal cancer screening, including fecal immunotesting, colonoscopy, and sigmoidoscopy among Utahns, and identify risk factors for non-screening through surveys of people in medically underserved communities; 2b) conduct a community-wide needs assessment survey at a mobile health clinic and health events around Salt Lake City to examine barriers to colorectal cancer screening in medically underserved populations from the patient perspective; and 2) Identify provider-reported barriers to colorectal cancer screening using interviews with provider-stakeholders. 

Inclusion Criteria

Adult patients 18+

Exclusion Criteria

Patients with Ulcerative Colitis, Crohn's Colitis, familial cancer syndromes that predispose to colorectal cancer, and patients who have or have been treated for colorectal cancer.