Barriers to screening colonoscopy in an urban population: a study to help focus further efforts to attain full compliance.

Background: Awareness of colorectal cancer and decision for colorectal cancer screening is influenced by multiple factors including ethnicity, level of education, and adherence to regular medical follow up.

Objective: Our survey aimed at assessing barriers to colorectal cancer screening among urban population.

Design: This study is a survey of the general population.

Setting: This study was made at a local community in the downtown area of a metropolitan city.

Patients/subjects: The study population for this survey included 2000 non-institutionalized residents from local community of Brooklyn downtown area of City of Brooklyn, NY, USA. All participants were 50 years or older.

Intervention: No intervention was done.

Main Outcome Measurement: The survey questionnaire collected information about demographic, socioeconomic level, awareness of various cancers and their screening methods, and awareness of screening colonoscopy.

Results: Colonoscopy was identified as the best screening test by 31 % of the subjects. Pain and discomfort was the major reason for not having a colonoscopy. The fear of a complication declined significantly after the first colonoscopy but fear of pain and discomfort increased. Difficulty with bowel preparation before a colonoscopy was a significant problem; it discouraged significant number of participants from having another colonoscopy.

Limitation: This study is limited by its small sample size.

Conclusion: Physician/family and peer influence seems important but influencing only a minority of subjects. Fear of complications should be allayed using accurate statistical information. Pain should be significantly diminished and/or eliminated during colonoscopy. Future research should focus to minimize complexity and discomfort associated with bowel preparation.