title: Primary care patients' understanding of colorectal cancer screening.
abstract: OBJECTIVE
  To determine the current level of awareness and understanding about colorectal cancer (CRC) and colorectal cancer screening (CRCS) among primary care patients in order to develop interventions to educate patients about options for CRCS, help them identify CRCS preferences and make informed choices about CRCS options.
  
  
  METHODS
  During the spring of 2001 and 2003, two sets of focus groups with primary care patients were conducted at a large multi-specialty group practice in Houston, Texas.
  
  
  RESULTS
  Participants (n = 42) in both sets of focus groups had low knowledge about CRC and expressed fear and embarrassment about CRC and CRCS. Attitudes towards the fecal occult blood test (FOBT) were mixed, with some participants considering it difficult to finish and others preferring the privacy it afforded. Some participants initially failed to recognize the difference between sigmoidoscopy (SIG) and colonoscopy (COL), and several endoscopy-specific barriers were identified such as fear of pain, embarrassment/humiliation, and dislike or fear of test preparation. Some participants felt that endoscopy was likely to be more effective than FOBT, and others clearly preferred COL to SIG. System-specific barriers to endoscopy (e.g. difficulty scheduling appointments and insurance coverage) were also identified. We found little change in the barriers reported by primary care patients, despite a two-year difference between focus groups. Participants also provided suggestions for improving CRCS including telephone, letters and/or email reminders from the clinic, videotapes and websites.
  
  
  CONCLUSIONS
  Future interventions focused on improving informed decision-making by educating primary care patients about the risks and benefits of specific test options and about the importance of early detection of CRC could prove to be effective for increasing CRCS.
authors.affiliation: Kelsey Research Foundation, 5615 Kirby, Suite 660, Houston, TX 77054, USA. ajgreisinger@kesley-seybold.com
authors.forename: Anthony
authors.initials: A
authors.lastname: Greisinger
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
authors.forename: Judy L
authors.initials: JL
authors.lastname: Bettencourt
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Perz
authors.forename: Sally W
authors.initials: SW
authors.lastname: Vernon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D011320:Primary Health Care; D012812:Sigmoidoscopy; D013689:Telephone