Population considerations:

  • Poor communication. A significant barrier to screening for women is poor communication with their health care providers (Brown, 2008).
  • Lack of provider recommendation. Women who have not been screened for colorectal cancer have reported that the lack of a recommendation from their health care provider was the most significant reason for neglecting to get screened (Stockwell et al, 2003).
  • Fear. Women have reported a fear of pain or discomfort with screening procedures as a barrier to getting screened along with finding out the results from the screening (Wolf, 2006).
  • Embarrassment. Women have reported that embarrassment is a reason why they often do not get screened (Wolf, 2006).
  • Lack of time. Women have reported that they may have trouble taking time off work to get screened (Clark, 2009).
  • Cost. Women have reported that the cost of the screening test is a reason that they choose not to get screened (Wolf, 2006).
  • Past sexual abuse. Past sexual abuse has been reported as a potential reason that women refuse colonoscopy. The procedure itself could possibly bring back memories of abuse (Wolf, 2006).
  • Preference for female doctors. Women may prefer a female doctor and choose to wait to be screened until a female doctor is available. In fact, some women will only be screened if it is done by a female doctor (Wolf, 2006).

  Strategies to address these considerations:

  • Educate providers. Educating health care providers on screening recommendations is necessary in order for them to make proper screening recommendations for their patients (Wolf, 2006). Providers must also be trained to tailor their methods to female patients in order to make them feel more comfortable.
  • Improve screening equipment. Improvements in the screening equipment, for example, variable flexible colonoscopies, may help increase the number of women who are screened (Wolf, 2006).
  • Promote healthy lifestyle changes. It is important to educate women on the lifestyle changes that will help them reduce their risk of colorectal cancer. Women can potentially reduce the risk of colon cancer by exercising, losing weight if overweight, taking adequate calcium, consuming folate and stopping tobacco use. Hormone therapy (estrogen plus progestin) may also reduce the risk of colorectal cancer in postmenopausal women (Wolf, 2006).
  • Increase knowledge and awareness. It is important to educate women about colorectal cancer in order to improve awareness and understanding of healthy lifestyle behaviors and screening methods. This may include role modeling and peer support.

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