title: Racial disparities and barriers to colorectal cancer screening in rural areas.
abstract: BACKGROUND
  This study examined barriers to colorectal cancer (CRC) screening in people living in rural areas.
  
  
  METHODS
  We identified 2 rural counties with high rates of CRC and randomly contacted county residents by telephone using a published listing.
  
  
  RESULTS
  Six hundred thirty-five of the 1839 eligible respondents (34.5%) between the ages of 50 and 79 years living in McDuffie and Screven counties, Georgia, agreed to complete the survey. The mean age was 62.2 years (SD, ±7.5 years); 72.4% were women, 79.4% were white, and 19.5% were African American. African-American respondents had lower CRC screening rates (50.4%) than whites (63.4%; P = .009). Significantly more African Americans compared with whites reported barriers to CRC screening. Based on logistic regression analyses, having a physician recommend CRC screening had the strongest association with having a current CRC screening, regardless of race.
  
  
  CONCLUSIONS
  Important racial differences existed between African Americans and whites regarding the barriers to CRC screening and factors impacting current screening. However, endorsement of a small set of questionnaire items--not race--had the strongest association with being current with screening. Physician recommendation for CRC screening had the strongest association with being current with CRC screening.
authors.affiliation: Department of Family Medicine, School of Medicine, George Health Sciences University, USA. twilkins@georgiahealth.edu
authors.forename: Thad
authors.initials: T
authors.lastname: Wilkins
authors.forename: Ralph A
authors.initials: RA
authors.lastname: Gillies
authors.forename: Stacie
authors.initials: S
authors.lastname: Harbuck
authors.forename: Jeonifer
authors.initials: J
authors.lastname: Garren
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Looney
authors.forename: Robert R
authors.initials: RR
authors.lastname: Schade
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005845:Georgia / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D054525:Minority Health; D016017:Odds Ratio; D010465:Perception; D011287:Prejudice; D012372:ROC Curve; D044469:Racial Groups / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D057566:Self Report; D013223:Statistics as Topic; D017741:Survivors; D044465:White People / Q000706:statistics & numerical data