The role of inadequate health literacy skills in colorectal cancer screening

Colorectal cancer is ideally suited for early detection strategies that are likely to improve survival rates. Screening with either a fecal occult blo od test (FOBT) or flexible sigmoidoscopy has been shown to identify precanc erous polyps or cancers in early stages. However, persons with limited educ ation and of lower socioeconomic status infrequently participate in screeni ng programs in general and have very low rates of colorectal screening. Low literacy, which is common among persons with limited education and low inc ome, may be an overlooked factor in understanding patients' decision making about colorectal cancer screening. This article provides information from focus groups about colorectal cancer screening, which we examine in the con text of relevant literature on cancer screening and literacy. Using the hea lth belief model, we examine the association between inadequate health lite racy skills and low rates of colorectal cancer screening. The theoretical m odel also provides insights into strategies for improving knowledge, attitu des, and beliefs and screening rates for this challenging patient populatio n.