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Ethn Health. 2018 Jul 4:1-18. doi: 10.1080/13557858.2018.1493438. [Epub ahead of print]

A qualitative study of barriers and enablers associated with colorectal cancer screening among Somali men in Minnesota.

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a Department of Family Medicine & Community Health , University of Minnesota Medical School , Minneapolis , USA.
b Office of the Legislative Auditor , Minnesota State Legislature , St Paul , Minnesota , USA.
c Lombardi Comprehensive Cancer Center, Georgetown University Medical Center , Washington , USA.
d University of Minnesota , Minneapolis , MN , USA.


The rate of cancer screening is generally increasing in the US. In Minnesota, the statewide average rate of screening for colorectal cancer (CRC) is 73%. However, screening completion is relatively low among Somali men; overall, only 27% of Somali immigrants have been screened for CRC. Factors contributing to this disparity have not been well researched. The purpose of this pilot study was to employ focus group methodology to describe and advance understanding of the barriers and enablers associated with CRC screening among Somali men ages 50-74 in Minnesota. Three focus groups were conducted among 27 Somali men in Minnesota. A 9-question, semi-structured interview guide was used. The sessions were audio recorded, transcribed verbatim, and checked for accuracy by research staff prior to data analysis. Three research team members utilized the constant comparative method and NVivo to conduct data analysis. Five barriers to CRC screening emerged from the analyses: (1) lack of knowledge, (2) emotional barriers, (3) acculturation, (4) accountability, and (5) fatalistic beliefs. In addition, two factors enabling CRC screening and prevention emerged: the need for tailored interventions and preventive lifestyle behaviors. The insights gained from this research will assist in developing health promotion and education-focused interventions that encourage Somali immigrants in Minnesota and beyond to seek early detection screening for CRC.


CRC: Colorectal Cancer; FIT: Fecal Immunochemical Test; FOBT: Fecal Occult Blood Test; FQHC: Federally Qualified Health Center; PA: Project Assistant; PI: Principal Investigator.


Barriers; Somali men; cancer early detection; colorectal cancer; health disparities; qualitative research

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