S600 Barriers to Colorectal Cancer Screening in Minority Populations: A Systematic Review of Qualitative Studies

Introduction: Colorectal cancer (CRC) screening significantly reduces mortality, still screening rates remain suboptimal among minority populations. Many barriers, involving individual, cultural and systemic issues, cause differences in how many people receive CRC screenings. By analyzing previous qualitative studies, this review identifies and groups the primary challenges to CRC screening in minority communities worldwide. Methods: Colorectal cancer (CRC) screening significantly reduces mortality, still screening rates remain suboptimal among minority populations. Many barriers, involving individual, cultural and systemic issues, cause differences in how many people receive CRC screenings. By analyzing previous qualitative studies, this review identifies and groups the primary challenges to CRC screening in minority communities worldwide. Results: This review includes 10 qualitative studies from the US, Mexico, and Denmark. Various barriers to CRC screening were identified across minority populations. The most common was lack of awareness or limited knowledge about CRC and screening, seen in 6 of 10 studies. Many Latino and immigrant participants held deep-seated views that interfered with screening, including fear of bad news, discomfort with medical procedures, or beliefs conflicting with heritage values. Healthcare system failures also contributed: high costs, long waits, digital record issues, and unclear follow-up processes. Some skipped screening due to disappointment with doctors, confusing information, or not understanding screening benefits. Barriers cited in ≥2 studies included lack of symptoms, physical limitations, language barriers, and reluctance to discuss health. Though each study examined different obstacles, similar issues recurred—some personal, others related to provider relationships, and many tied to healthcare system structure. Conclusion: The results demonstrate that there are a variety of problems faced at individual, cultural and system-wide levels. Although we did not code communication issues as barriers, low trust and poor health literacy were present in most cases. The findings emphasize that a combination of education, FIT screening and better relationships with health professionals are needed to fix CRC screening issues among minority groups.