Barriers and Facilitators of Colorectal Cancer Screening in a Federally Qualified Health Center (FQHC)

Kelly R. Ylitalo, PhD; Brendan G. Camp, MPH; M. Renée Umstattd Meyer, PhD, MCHES; Lauren A. Barron, MD; Gabriel Benavidez, BS; Burritt Hess, MD; Ryan Laschober, MD; Jackson O. Griggs, MD


J Am Board Fam Med. 2019;32(2):180-190. 

In This Article


The prevention of colorectal cancer in low-income, minority patient populations is multifaceted. Racial/ethnic minorities and Spanish speakers experience significant barriers to FIT return compared with their English-speaking, non-Hispanic white counterparts. Tailored interventions may maximize FIT return and increase colorectal cancer screening rates in resource-limited community health centers across the nation. Understanding patient and clinician perspectives for colorectal cancer screening may be an important step to increase screening rates and thereby identify early-stage cancer. Bilingual community health workers may increase screening rates by serving as patient navigators, providing live call reminders to patients, and mitigating psychosocial factors such as fear and embarrassment with culturally appropriate interventions. Disseminating accurate information to clinicians may increase awareness about colorectal cancer screening modalities and clinic-specific screening workflow processes. Given recent data about colorectal cancer incidence and mortality for race/ethnic minority groups and adults aged 40 to 54 years, these tailored education and intervention efforts for both clinicians and patients may increase cancer screening adherence among adults across the life course.