Lou Portero

Urban Health Today

A recent mixed-methods systematic review published in <a href="https://www.sciencedirect.com/science/article/pii/S2211335524003693?via%3Dihub">Preventive Medicine Reports</a>, explores the barriers and facilitators affecting colorectal cancer (CRC) screening among Black men, a group disproportionately impacted by higher CRC mortality rates compared to other racial groups. Despite colorectal cancer being preventable with early detection, only 61% of eligible Black adults reported being current with screening as of 2021—well below the national goal of 80%.
The study synthesized data from 54 peer-reviewed articles published between 2009 and 2022, identifying critical barriers including limited CRC knowledge, poor patient-provider communication, access issues, and deep-seated medical mistrust arising from systemic racism. Conversely, significant facilitators identified were aging, receiving regular primary care provider recommendations, social support, and culturally appropriate outreach strategies.
Lack of knowledge about CRC screening was a particularly significant obstacle. Many Black men were unaware of screening options or confused colorectal cancer with other cancers, highlighting a critical opportunity for education. Emotional factors such as fear, fatalism, and embarrassment also substantially discouraged screening participation, emphasizing the need for culturally sensitive patient-provider conversations.
Interpersonal relationships, specifically the role of healthcare providers, proved vital in promoting screening adherence. A recommendation from a primary care provider emerged as the single most powerful facilitator for CRC screening, underscoring the importance of clear and proactive communication in healthcare settings.
Access issues, such as financial barriers and transportation difficulties, were prevalent. Providing convenient screening methods like stool-based tests and patient navigation programs were recommended as effective strategies. Community-level support and culturally tailored health messaging further contributed positively.
Medical mistrust due to systemic racism remains a formidable societal barrier. Building trust through sustained patient-provider relationships, shared decision-making, and targeted outreach programs emerged as essential components in addressing this challenge.
The researchers conclude that primary care teams are uniquely positioned to implement culturally appropriate, targeted strategies to significantly enhance CRC screening rates among Black men, ultimately reducing disparities and improving health outcomes.

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Only 61% of eligible Black adults reported being current with screening as of 2021—well below the national goal of 80%.

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