Evidence map›Paper›PMID 25481094›Full record

SynthesisPreventive medicine2015

Explaining persistent under-use of colonoscopic cancer screening in African Americans: a systematic review.

Erica G Bromley, Folasade P May, Lisa Federer, Brennan M R Spiegel, Martijn G H van Oijen

Open access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Preventive medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 6 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 6 syntheses or guidelines pooled it, 93 citations in OpenAlex.

  1. Pooled it
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  3. Barriers and Facilitators to Participation in Health Screening: an Umbrella Review Across Conditions.Prevention science : the official journal of the Society for Prevention Research · 2022
    Pooled it
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  7. Trial
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  10. Article
  11. Understanding the Impact of Psychosocial Barriers on Colorectal Cancer Knowledge in Emerging Adult Black Men.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
    Article
  12. Article
  13. Article
  14. Black-White disparities across the colorectal cancer care continuum in the USA.Nature reviews. Gastroenterology & hepatology · 2025
    Review
  15. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Erica G BromleyDepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA, USA.
Folasade P MayDepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA, USA. Electronic address: fmay@mednet.ucla.edu.
Lisa FedererUniversity of California Los Angeles, Los Angeles, CA, USA.
Brennan M R SpiegelDepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; UCLA/VA Center for Outcomes Research and Education (CORE), Los Angeles, CA, USA.
Martijn G H van OijenDepartment of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; University of Utrecht, The Netherlands.
University of California, Los Angeles · US

Funding

Pilot and Feasibility ProgramP30DK041301 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ROZENGURT, JUAN ENRIQUE · 1990 to 2019
$18.0M
GASTROENTEROLOGYT32DK007180 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JENSEN, DENNIS MICHAEL · 1986 to 2025
$10.0M
NIDDK NIH HHS P30 DK041301NIDDK NIH HHS T32 DK007180
6 · The paper itself

Abstract

introductionAlthough African Americans have the highest incidence and mortality from colorectal cancer (CRC), they are less likely than other racial groups to undergo CRC screening. Previous research has identified barriers to CRC screening among African Americans. However we lack a systematic review that synthesizes contributing factors and informs interventions to address persistent disparities.

methodsWe conducted a systematic review to evaluate barriers to colonoscopic CRC screening in African Americans. We developed a conceptual model to summarize the patient-, provider-, and system-level barriers and suggest strategies to address these barriers.

resultsNineteen studies met inclusion criteria. Patient barriers to colonoscopy included fear, poor knowledge of CRC risk, and low perceived benefit of colonoscopy. Provider-level factors included failure to recommend screening and knowledge deficits about guidelines and barriers to screening. System barriers included financial obstacles, lack of insurance and access to care, and intermittent primary care visits.

conclusionsThere are modifiable barriers to colonoscopic CRC screening among African Americans. Future interventions should confront patient fear, patient and physician knowledge about barriers, and access to healthcare services. As the Affordable Care Act aims to improve uptake of preventive services, focused interventions to increase CRC screening in African Americans are essential and timely.

Indexed as

Health Knowledge, Attitudes, PracticePatient CompliancePhysician-Patient RelationsAgedBlack or African AmericanClinical CompetenceColonoscopyColorectal NeoplasmsFemaleHealth Services AccessibilityHumansInsurance, HealthMaleMiddle AgedPatient Protection and Affordable Care ActUnited StatesAfrican-AmericanBarriersColonoscopyColorectal cancerEthnicityRaceScreening

Identifiers

PMID25481094
PMCPMC4329030
OpenAlexW2010434960

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.