title: Barriers to endoscopic colorectal cancer screening: are women different from men?
abstract: OBJECTIVE
  The goals of this study were to compare women and men's understanding of screening flexible sigmoidoscopy (FS) and to identify predictors of endoscopic colorectal cancer (CRC) screening.
  
  
  METHODS
  We mailed a 36-item questionnaire to asymptomatic patients aged 50 years or older who were scheduled for routine health assessments at a large multispecialty health-care group. Data collection included demographics, health behaviors, psychosocial factors, and CRC screening compliance. We followed participants for 1 year and assessed completion of endoscopic CRC screening. Both cross-sectional results examining previous screening and prospective results examining screening 1 year later were evaluated.
  
  
  RESULTS
  554 (54%) of 998 patients responded to the survey. Responses of 13 patients were excluded in the analyses due to unverifiable screening outcome. The majority of the respondents were white, and their average age was 62 years. Women reported significantly more embarrassment and fear about having FS than men. Women were more willing to consider having a FS if a female endoscopist performed the procedure. Of the 334 participants who were eligible to have endoscopic CRC screening, 53 (16%) had the procedure within a year. The odds of having the endoscopic procedures increased with the length of time the patients were under the care of their primary care providers and how strongly patients believed that one should have an FS even without symptoms.
  
  
  CONCLUSIONS
  Our findings suggest some unique gender-specific attitudes and beliefs that act as potential barriers for CRC screening and further support the important role of primary care providers in facilitating timely completion of screening.
authors.affiliation: Section of Gastroenterology, Boston Medical Center, Massachusetts 02118, USA.
authors.forename: Francis A
authors.initials: FA
authors.lastname: Farraye
authors.forename: Mei
authors.initials: M
authors.lastname: Wong
authors.forename: Shelley
authors.initials: S
authors.lastname: Hurwitz
authors.forename: Elaine
authors.initials: E
authors.lastname: Puleo
authors.forename: Karen
authors.initials: K
authors.lastname: Emmons
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wallace
authors.forename: Robert H
authors.initials: RH
authors.lastname: Fletcher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011446:Prospective Studies; D012737:Sex Factors