Overcoming Barriers to Colorectal Cancer Screenings


The third of a four-part series regarding colorectal cancer (CRC) screenings

Thank you for your continued support and interest in colorectal cancer screenings for our members. Please refer to the June 2023 Blue Review publication for first article titled, Colon Cancer Screenings Goal: 80% In Every Community and our second article published in August 2023 titled Colorectal Cancer Screening Options and Statistics – Get the Conversation Started Today.

The series now continues with article three, Overcoming Barriers to Colorectal Cancer Screening.

Patient Concerns


  • Patients feel embarrassed about bowel functions and/or tests that involve stool collection.
  • Inform patients that there are several screening options available, including simple take home tests that can be completed in the privacy of their own home.

Gaps in Knowledge:  Facts people may not know about Colorectal Cancer and Colorectal Cancer Screenings

  • Even if patients feel fine, being asymptomatic does not equate to an absence of cancer.
  • Let patients know that many people diagnosed with colon cancer do not have any symptoms or a family history, which is why screening is so important even when they feel healthy.
  • Most people diagnosed with CRC have no family history. The risk of having CRC is higher when a close relative has had it.
  • More advanced CRC are being seen in younger people.
  • Colorectal cancer is estimated to become the leading cause of cancer-related deaths ffor 20-49-year-olds by 2030.[1]                                

Additional Gaps in Knowledge

  • Be mindful of social determinants of health such as the patients’ low health literacy, language barriers, transportation, financial insecurity or no available companion. Discuss the variety of CRC screening options, in a way your patients can understand as well as individual considerations that may impact CRC screening test selection.
  • Once a CRC screening option is agreed upon, explain the expectations and process. Assure that medications for discomfort will be provided for CRC screening procedures. Patient brochures and information are available.[2]

Concerns Regarding Costs and/or Interruption of Daily Life Responsibilities

  • Although CRC screenings are a preventive measure, there may be affiliated out-of-pocket costs. Loss of work and/or lack of transportation may be a concern with a flexible sigmoidoscopy or colonoscopy.
  • Inform patients that preventing colorectal cancer or finding it early does not have to be expensive. There are simple, affordable tests available.
  • Encourage patients to contact their BCBSTX customer service representatives to discuss benefits and coverage.

Provider Concerns

Limited Patient Visit Time

  • Addressing acute or chronic conditions may take precedence over preventive care during a visit.
  • Inaccurate EMR reminders, lack of interoperable EHRs and trackable documentation inhibit an optimal clinic workflow. Office systems that “flag” patients needing CRC screenings are advantageous.
  • Train your staff to identify patients with gaps in preventive care to allow for focused and efficient use of your time.

Familiarity with Recommended CRC Screening Options

  • Various factors determine which option is best for each patient.
  • Structure didactics for staff; educate staff on latest CRC guidelines and evidence-based screening options eligibility.
  • Stocking Fecal Immunochemical Testing (FIT) kits in the office, to dispense during visits, can be effective. When patients agree to FIT testing, allow them to open the kit, handle the materials and complete the paperwork. The mystery will be removed if they can visualize the test and ask questions. They will also be more likely to complete the CRC screening if they feel confident in the process.

Culturally Competent

  • Is your staff culturally competent? Use preferred language messaging. Use our free Language Line translation service during the office visit if necessary.
  • Ask questions to ensure the patient understands you.
  • Having printed materials available in the waiting room may encourage conversations.

Resources to Follow Up on Positive CRC Screenings

You may be concerned that patients with positive CRC screening results may not have access to gastroenterologists or cancer treatment specialists.

Review the availability of local resources to alleviate this concern or have patients call the number on the back of their member ID card to discuss resources.


1 https://nccrt.org/80-in-every-community-2/#1686669856662-9b5ce79e-8269

2 https://www.nccn.org/patientresources/patient-resources/guidelines-for-patients/guidelines-for-patients-details?patientGuidelineId=61