Gastroenterology Research and Practice / 2012 / Article / Tab 3

Research Article

What Would Make Getting Colorectal Cancer Screening Easier? Perspectives from Screeners and Nonscreeners

Table 3

Selected illustrative quotes.

Patient-related scheduling barriers
My own scheduling issues (early-screener).
If I had more flexible times available (late-screener).
 I am a teacher. Once the school year has ended, I can set up a time (nonscreener).
My daughter has been ill for the last six months. I have to drive my daughter and I have care-giving duties for my mother (nonscreener).
I have tried to be tested several times but have had to reschedule. I am scheduled for my GI consultation February 13 with Dr. [name withheld] (nonscreener).

System-related scheduling barriers
I tried to schedule but a convenient time has not been found (nonscreener).
When I called to get a colonoscopy, they told me to get a consult. I did not see the use of the consult. It could be done right before the colonoscopy (nonscreener).
I’m waiting for them to call me back so that I can get a colonoscopy (nonscreener).

External screening barriers: financial/insurance barriers
I would have liked to have known how much it was going to cost. I would not have done it at that time (early-screener).
I had a problem coming up with the deductible, so I had to reschedule (late-screener).
Although I was scheduled, I could not afford the copay (nonscreener).
I changed insurance and the new insurance would not cover as much of it. It would have been very expensive (nonscreener).

External screening barriers: medical conditions
Because I had the flu and the doctor directed me to postpone having the colonoscopy (early-screener).
I had a physical problem-bad hemorrhoids (late-screener).
I had a heart condition that required hospitalization and caused me to postpone my plans for screening (nonscreener).
I have had several health problems. I cannot think of colon cancer screening (nonscreener).

External screening barriers: patients disliked screening test requirements
Drinking the water/prep was the problem (early-screener).
The laxative stuff is hard to get through (early-screener).
The drink that you have to drink was horrible. If that tasted better (early-screener).
If they had an easier testing process like swallowing a camera. I do not like the purging process (nonscreener).
If I did not have to do the FOBT at all—it was kind of a hassle since I had to do it over 3 days at home (nonscreener).

External screening barriers: perceived lack of physician direction
At the physical, the physician did not push me to do any screening (nonscreener).
My doctor’s decision would have made it easier, but the doctor is still telling me to wait and see (nonscreener).

External screening barriers: transportation needs
I felt that I could have driven myself home after the test. That is what kept me from doing it sooner. I had to find someone to drive me there (early-screener).
I do not have anyone to drive me to the testing for a colonoscopy (nonscreener).

Internal screening barriers: low salience for screening
No. It’s just me. I’m trying to plan around work and I’m just lazy (late-screener).
Just not on my radar right now (nonscreener).
I have a FOBT kit, but I have not done the test (nonscreener).

Internal screening barriers: low perceived need for CRCS
If I thought I had symptoms and was ill then I would have been tested (early-screener).
I do not feel a need for it. My stools are ok and I feel ok (nonscreener).
At the doctor’s office, they did a rectal exam. They did not recommend anything further. I thought that was all that was needed (nonscreener).

Internal screening barriers: information needs
Maybe seeing a video clip from an actual screening procedure to be better prepared for what is going to happen during the test (early-screener).
I would have liked more information about the procedure (nonscreener).

Internal screening barriers: emotional concerns
I did not feel anything during the procedure and I think it would have been easier to get tested if I had known that I really would not have any pain (early-screener).
It would help me complete testing if I could take away some of the fear of the procedure (nonscreener).

GI: gastroenterology; CRCS: colorectal cancer screening; FOBT: fecal occult blood test.

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