María E. Fernández, PhD, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin Suite 2558, Houston, TX 77030, 713-500-9626, maria.e.fernandez@uth.tmc.edu and Rosario C. Wippold, RNC, MPH, Center for Health Promotion and Prevention Research, University of Texas, School of Public Health, 7000 Fannin suite 2576 E, Houston, TX 77030.

Objective: The purpose of this study was to identify factors influencing the decision to undergo colorectal cancer screening (CRCS) among low-income Hispanics living along the Texas–Mexico border. Although, colorectal cancer is a leading cause of cancer death among Latinos, most are not getting the recommended colorectal cancer screening (CRCS) tests, and little is known about what factors influence informed decision making for CRCS among Latinos.

Method: Four focus groups with low-income Latino men and women were conducted in January 2004 in Brownsville, El Paso, and Laredo, Texas. Demographic, psychosocial, and cultural factors potentially related to CRCS were addressed, as well as access to health care services, perceptions about the importance of preventive health care, and factors surrounding health care decision making. Most participants in this study knew very little about colorectal cancer and even less about CRCS. Many of them were confused about the differences between colorectal cancer and stomach or prostate cancers. There were many misconceptions about the major causes of colorectal cancer. Individual-level barriers to CRCS suggested by participants included embarrassment, machismo, lack of knowledge and information, procrastination, fear of questioning physicians, fear of the actual screening procedures, and fear of receiving a diagnosis of cancer. Other barriers to CRCS identified by participants included lack of health insurance or financial resources, being undocumented, and transportation barriers.

Results: Lack of knowledge, misperceptions about CRC and CRCS, personal level barriers such as embarrassment and fear and system level barriers such as cost, and health insurance are some of the factors influencing CRCS behavior in this population that are further analyzed in this study.

Learning Objectives: