Barriers and facilitators of colorectal cancer screening in a federally-qualified health center : patient and clinician perspectives.

Colorectal cancer (CRC) is a leading cause of cancer-related mortality in the United States. Current screening recommendations for individuals aged 50 to 75 years include colonoscopy every ten years, flexible sigmoidoscopy every five years, and/or annual stool-based testing. Stool-based testing, and specifically fecal immunochemical tests (FIT), are cost effective, easy to perform at home, and non-invasive. Efforts to enhance CRC screening has been effective the past few decades. Yet, many patients fail to return testing kits and remain unscreened. The purpose of the thesis was to evaluate perceived barriers and facilitators of FIT return in a Federally-Qualified Health Center. Patients who received a FIT order from January 1, 2017 to July 1, 2017 were enumerated (n=1498). After exclusion criteria, analysis of FIT returners (n=440) and FIT non-returners (n=435) was conducted to compare sociodemographic and health characteristics. Telephone surveys assessed barriers and facilitators of the CRC screening process for non-returners (n=121).