Barriers to Colorectal Cancer Screening in Southeastern Wisconsin Communities

Project Description Narrative:

Colorectal cancer (CRC) is the fourth most incident and the second leading cause of cancer-related death in the U.S. CRC mortality rates for men and women in Wisconsin are higher than the U.S. average and greater for the southeastern region compared to the statewide rate. Evidence from randomized longitudinal efficacy trials consistently shows a significant reduction in CRC mortality associated with screening. Medicare legislation was enacted in 1998 to cover screening costs for all beneficiaries; HMOs are following suit. Despite the effectiveness and availability of screening to the insured, it is estimated that less than half of the population in this age cohort is currently screened in accordance with CRC guidelines. For the uninsured, screening rates are much lower. Several research studies have examined individual-level barriers to CRC screening behavior, but little detailed information exists at the more easily modifiable macro or system levels. Pilot clinical data suggest that these factors may play a much greater role for screening update compared to individual-level factors. This goal of this project is to gather preliminary data for an eventual CRC screening intervention study.