Reflection statement for participants in this CME activity:

Non-adherence to screening guidelines for colorectal cancer is a significant problem in the U.S. despite the proven morbidity / mortality benefits of such screening. Women have been identified previously to have higher rates of non-adherence. This study replicated this finding and additionally noted several sociodemographic variables associated with non-adherence to screening recommendations for colorectal cancer among women hospitalized for other reasons.

Since colorectal cancer is common, can be readily detected at early stages by current screening strategies, and causes substantial morbidity and death when detected beyond early stages, it is tragic to note that low utilization rates (roughly 50%) exist for recommended colorectal screening even though screening has been proven to substantially reduce deaths due to colorectal cancer.

This study suggests that studying factors that are associated with nonadherence may allow physicians to better overcome non-adherence in the future. This study also acknowledged the potential value of targeting women who are hospitalized may be an opportunity to identify women who are non-adherent to colorectal screening recommendations and providing  them with interventions such as counseling, education, or other approaches to motivate them to overcome their non-adherence to colorectal screening recommendations.

Learning more about factors that lead to non-adherence in identifiable contexts may offer opportunities to improve the health of more people. How to apply such knowledge appropriately to reduce non-adherence to highly effective interventions to reduce morbidity and mortality due to some important conditions may be challenging. Past and ongoing experience with non-adherence suggests it often cannot be easily overcome despite the clear and profound benefits of adherence to recommendations for conditions which have extremely strong evidence to support recommended interventions (e.g. smoking cessation, colorectal screening, many vaccinations, controlling hypertension, controlling obesity, etc.). Perhaps maintaining trust plus improving understanding of drivers for non-adherence may allow some progress for the time being.