Barriers and Facilitators of Colorectal Cancer Screening During the COVID-19 Pandemic

• Published in: The American surgeon 2024-06, Vol.90 (6), p.1217-1223
• Main Authors: Miller, Carrie A., Guidry, Jeanine P. D., Kenning, Kristine L., Bohl, Jaime L., Fuemmeler, Bernard F., Rivet, Emily B.
• Format: Article
• Language: English
• Subjects: Aged; Colonoscopy - statistics & numerical data; Colorectal Neoplasms - diagnosis; COVID-19 - epidemiology; Cross-Sectional Studies; Early Detection of Cancer - statistics & numerical data; Female; Health Services Accessibility; Humans; Male; Middle Aged; Pandemics; Patient Acceptance of Health Care - statistics & numerical data; SARS-CoV-2; Surveys and Questionnaires
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/00031348241227216

Background COVID-19 introduced new barriers to health care including cancer screenings. This study evaluated the role of pandemic- and copay-related barriers to colonoscopy and the extent to which home-based testing methods were utilized. Methods A cross-sectional survey assessed colorectal cancer (CRC) attitudes and screening early in the COVID-19 pandemic. Results Respondents (342; 50.37% female) were 62.32 (SD = 6.87) years old. Roughly half were White/Caucasian (329; 48.45%); 29.75% were Black/African American (202); and 21.80% were another race (148). Roughly two-thirds were up-to-date with CRC screening (459; 67.59%). In an adjusted model, those with a higher agreement that concerns about COVID-19 delayed scheduling their colonoscopy (OR = .79; 95% CI: .08, .63; P = .045) and concerns about copays delayed scheduling their colonoscopy (OR = .73; 95% CI: .73, .57; P = .02) were less likely to be up-to-date on screening. In another adjusted model, those screened during the pandemic were significantly more likely to be screened via an at-home test (OR = 10.93; 95% CI: 5.95, 20.27; P < .001). Discussion During the COVID-19 pandemic, screening copay-related concerns persisted and were significantly higher among those not up-to-date with CRC screening. Increased at-home testing and addressing copay barriers may increase CRC screening adherence now and in future infectious disease outbreaks.