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Health Services Research & Development

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2006 HSR&D National Meeting Abstract


3050 — Differences in Colorectal Cancer Screening Barriers and Preferences Among Female and Male Veterans

Author List:
Friedemann-Sánchez G- (CCDOR)
Griffin JM (CCDOR)
Partin MR (CCDOR)

Objectives:
Four screening modalities have been found to be efficacious at reducing colorectal cancer (CRC) mortality: Fecal Occult Blood Test, sigmoidoscopy, Double Contrast Barium Enema, and colonoscopy. National data suggest that women are less likely to be screened for CRC than men. Predictors of this gendered difference have not been studied. The objective of this qualitative research study was to examine mode-specific gender differences in colorectal cancer screening barriers and preferences.

Methods:
Six focus groups were conducted with male and four with female veterans receiving primary care from the Minneapolis VAMC to elicit information about barriers, facilitators, and preferences to four screening modes. The groups were stratified by screening status (screened/unscreened). Six to eight individuals participated per group. A semi-structured interview guide was developed to assess perceptions, attitudes, beliefs, and preferences about CRC screening options. Discussions were recorded, transcribed, coded, and analyzed according to the conceptual domains present in the interview guide. As is standard practice in qualitative methods, the analysis incorporated domains that arose during the discussions.

Results:
Previous studies on CRC screening preferences have found that patients prefer colonoscopy and FOBT at nearly equal rates. Our findings indicate similar screening mode preferences (both females and males preferred colonoscopy) and attitudes about the relative importance of colorectal versus reproductive cancer screening (both perceived screening for reproductive cancers as higher priority), but notable differences in barriers to screening completion and information preferences. For instance, women who had a prior endoscopic procedure viewed the required preparation as a major barrier to screening, while men did not. Women preferred receiving extensive information regarding endoscopic procedures, while men preferred receiving little or no information. Women and men also expressed significantly different fears (affective versus physical respectively). Finally, women perceived CRC as a male disease thus feeling less vulnerable to CRC.

Implications:
Men and women have similar preferences for screening mode options but express different barriers to screening completion. Women and men express different CRC screening information preferences.

Impacts:
Tailoring educational materials to gender specific barriers may be warranted and may improve screening among female veterans


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