S528 Barriers to Colonoscopy: A Racial Analysis of Knowledge, Colonoscopy Beliefs, and Experience Among New Yorkers

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death in the United States and also in New York (NY). Despite CRC screening recommendations, colonoscopy uptake for screening or follow-up of an abnormal stool test varies widely among different racial and ethnic groups. This study aimed to assess knowledge, beliefs, and experiences with colonoscopy across diverse populations in New York to inform future interventions to improve colonoscopy uptake. Methods: We conducted a questionnaire survey to collect data across 3 healthcare facilities in Brooklyn, New York. Descriptive analyses assessed colorectal cancer screening knowledge, beliefs, and experiences across different racial groups. The level of significance was at P-value < 0.05. Results: The survey response rate was 95/100 (95%) of respondents. Majority were between the ages of 55-74 years old (54.25%, P = 0.0644), Black (77.66%, P < .0001), Female (60%, P = 0.0513), High school/GED (49.46%, P < .0001), Single (45.74%, P < .0001), Employed (42.55%, P = 0.0994), Non-substance user (65.66%, P = 0.0032), Insured (97.85%, P < .0001) and Had access to healthcare (96.81%, P < .0001 ). Respondents across all racial groups reported awareness of CRC symptoms, with 80% of White, Asian, and 91.78% of Black, and all Hispanic respondents (100%) affirming knowledge. Colonoscopy was the most widely recognized method, highest in Black (91.30%), Asian (80%), Hispanic (81.82%), and White (60%) respondents. Stool-based tests were most recognized by White (40%) and Hispanic (18.18%). More than 50% of respondents across all races were unaware of the new starting age (45 years) of CRC screening. In terms of colonoscopy belief and experience, over half of the respondents were satisfied with their prior colonoscopies, but some Asian (60% vs 40%) and Black (43.06% vs 29.58%) reported it discomforting vs painful experience compared to White and Hispanic. Most respondents across all racial groups believed colonoscopy is effective in early CRC detection. Conclusion: This study revealed notable gaps in knowledge of the starting age of CRC screening, which is a vital piece of CRC awareness. Also, we found racial disparities in colonoscopy beliefs among minority groups (Black and Asian respondents), which may be barriers to colonoscopy completion. We recommend tailored and culturally sensitive education and outreach to improve colonoscopy uptake across diverse communities.