Cancer Prevention & Control, Client-Oriented Screening Interventions: Reducing Structural Barriers

(2008 Archived Review)

Task Force Finding*

Structural barriers are non-monetary obstacles that impede access to screening, such as inconvenient hours or locations for screening, complex administrative procedures, requirements for superfluous clinic visits, or lack of needed translation services. Efforts to reduce structural barriers may be combined with measures to provide client education, information about program availability, or measures to reduce out-of-pocket costs.

The Task Force recommends reducing structural barriers to increase screening for breast and colorectal cancers (by mammography and FOBT, respectively) on the basis of strong evidence of effectiveness. Evidence is insufficient, however, to determine whether reducing structural barriers is effective in increasing colorectal cancer screening by flexible sigmoidoscopy, colonoscopy, or double contrast barium enema, because no studies using these screening procedures were identified. Evidence was also insufficient to determine the effectiveness of the intervention in increasing screening for cervical cancer because only two relevant studies were identified, and these had some methodological limitations.

*From the following publication:

Task Force on Community Preventive Services. Recommendations for client- and provider-directed interventions to increase breast, cervical, and colorectal cancer screening. [PDF - 74KB] Am J Prev Med 2008;35(1S):S21–5.