Dr. O'Malley on Racial and Economic Barriers to Screening in CRC

Denalee O'Malley, PhD, assistant professor, Department of Family Medicine and Community Health, Research Division, Rutgers Robert Wood Johnson Medical School, discusses racial and economic barriers to colorectal screening in colorectal cancer (CRC).

The disparities that affect screening for CRC stem from structural racism embedded in the health-care delivery system, O'Malley says. These disparities are interconnected, and they include racism, income inequality, geographic disparities, and the organization and delivery of health care, O'Malley explains.

Moreover, there are many different types of CRC screening tests, all with different levels of efficacy and intervals of testing, O’Malley adds. A FIT test is an annual screening, compared with a colonoscopy, which involves a 10-year interval if tests come back normal, O’Malley continues.

Community health centers play a key part in screenings, as they are considered a primary care safety net, O’Malley explains. However, over 20% of community health center patient populations are uninsured, adding another disparity to screening, O’Malley concludes.