Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 15;13(12):909-918.
doi: 10.1093/tbm/ibad057.

Patient perspectives on a proposed pharmacy-based colorectal cancer screening program

Renée M Ferrari  1   2 , Dana L Atkins  3 , Mary Wangen  4 , Catherine L Rohweder  4 , Austin R Waters  5 , Sara Correa  1 , Jennifer Richmond  6 , Dillon van Rensburg  7 , Annika Ittes  3 , Olufeyisayo Odebunmi  5 , Rachel B Issaka  3   8 , Rachel Ceballos  9 , Parth D Shah  3 , Stephanie B Wheeler  1   5 , Alison T Brenner  1   4   10
Affiliations

Patient perspectives on a proposed pharmacy-based colorectal cancer screening program

Renée M Ferrari et al. Transl Behav Med. .

Abstract

Colorectal cancer (CRC) is a common and preventable cancer. CRC screening is underutilized, particularly within medically underserved communities. Most interventions aimed at increasing CRC screening are delivered through primary care clinics. Pharmacies are more accessible than traditional primary care settings and may be ideally suited for delivering CRC screening and increasing access. Fecal immunochemical test is an at-home, stool-based CRC screening test that could be distributed through pharmacies. The purpose of our study was to assess patient perspectives on receiving fecal immunochemical test-based CRC screening through pharmacies. We conducted semi-structured interviews with participants residing in North Carolina and Washington. Interviews explored acceptability and intervention design preferences for a pharmacy-based CRC screening program. The interview guide was informed by Andersen's Healthcare Utilization Model and the Theoretical Domains Framework. Interviews were conducted at the University of North Carolina at Chapel Hill and Fred Hutchinson Cancer Research Center, audio-recorded, and transcribed. Patients perceived a pharmacy-based CRC screening program to be highly acceptable, citing factors such as ease of pharmacy access and avoiding co-pays for an office visit. Some concerns about privacy and coordination with patients' primary care provider tempered acceptability. Trust and positive relationships with providers and pharmacists as well as seamless care across the CRC screening continuum also were viewed as important. Patients viewed pharmacy-based CRC screening as an acceptable option for CRC screening. To improve programmatic success, it will be important to ensure privacy, determine how communication between the pharmacy and the patient's provider will take place, and establish closed-loop care, particularly for patients with abnormal results.

Keywords: FIT; colorectal cancer; pharmacy; screening; uninsured.

Plain language summary

Colon cancer is a common and preventable cancer in the USA and testing for colon cancer can be done at home with a simple test. Yet, many people remain unscreened. This is particularly true for people who may not have ready access to health care, such as those who have limited incomes or resources or who live in rural areas. Most people live close to a pharmacy and visit a pharmacy more frequently than a primary care office. Pharmacies commonly offer services beyond medication dispensing (e.g. flu shot, diabetes management), making them a potential avenue for increasing colon cancer screening. This study aimed to learn what patients think about receiving colon cancer screening through pharmacies. We interviewed 32 people who fit the age-range recommended for colon cancer screening. They were open to, even embracing of, getting screened for colon cancer through a pharmacy, primarily because of its convenience, accessibility, and because it would not require a co-pay. At the same time, they emphasized the need for privacy and coordination with their primary care provider. We concluded that colon cancer screening in pharmacies is potentially a good option for people, provided they have privacy and that their primary care providers are informed.

PubMed Disclaimer

Conflict of interest statement

Annika Ittes is employed by and owns stock in Genentech, Inc., as of May 2022. Rachel Ceballos received pilot funding for a project titled “A Multilevel Approach to Improving Colorectal Cancer Screening in Rural Communities of the FH/UW Catchment Area.” Stephanie Wheeler received grant money paid to her institution from The Pfizer Foundation, through December 2022. All other authors declare no conflict of interest.

Figures

None
Graphical abstract
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Fuchs HEet al. Cancer statistics, 2021. CA Cancer J Clin 2021;71:7–33. 10.3322/caac.21654 - DOI - PubMed
    1. Davidson KW, Barry MJ, Mangione CMet al.; US Preventive Services Task Force. Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA 2021;325:1965–1977. 10.1001/jama.2021.6238 - DOI - PubMed
    1. Lin JS, Perdue LA, Henrikson NBet al. Screening for colorectal cancer: updated evidence report and systematic review for the US preventive services task force. JAMA 2021;325:1978–1998. 10.1001/jama.2021.4417 - DOI - PubMed
    1. Knudsen AB, Rutter CM, Peterse EFPet al. Colorectal cancer screening: an updated modeling study for the US preventive services task force. JAMA 2021;325:1998–2011. 10.1001/jama.2021.5746 - DOI - PMC - PubMed
    1. Increase the Proportion of Adults Who Get Screened for Colorectal Cancer—C-07—Healthy People 2030. health.gov. https://health.gov/healthypeople/objectives-and-data/browse-objectives/c... (29 September 2022, date last accessed).