Barriers to FIT Completion Persist Among Asian American Patients

• A survey-based study evaluated 334 Asian American nonresponders in a mailed fecal immunochemical test (FIT) program at a large academic center; 201 were contacted and 30 completed the survey. Previous FIT uptake was 16%.

• Although 70% rated colorectal cancer screening “very important,” fewer than half knew the recommended starting age; 90% understood polyps, and two-thirds reported prior screening.

• Reported barriers included limited time, perceived up-to-date screening, stool-collection discomfort, colonoscopy preference, and FIT accuracy concerns. Suggested strategies included simpler kits, additional reminders, and direct clinician discussions.

Colorectal cancer (CRC) screening participation remains low among Asian American patients despite high awareness of its importance, according to a survey-based study evaluating barriers to fecal immunochemical test (FIT) completion. The findings highlight a disconnect between perceived value of screening and real-world follow-through.

The study examined patients enrolled in a mailed FIT outreach program at a large academic center, where uptake among Asian American patients had previously been only 16%. Among 334 eligible individuals who did not return a FIT kit, 201 were contacted and 30 completed a survey assessing knowledge, attitudes, and barriers.

Most respondents recognized the importance of screening, with 70% reporting that CRC screening is “very important.” However, knowledge gaps persisted, with fewer than half correctly identifying the recommended starting age. While 90% reported understanding what a colon polyp is and two-thirds had prior screening, participation in the FIT program remained low.

Barriers were primarily practical rather than educational. Among respondents who recalled receiving a FIT kit, many did not open it or failed to complete it. The most common reasons included lack of time, perception of being up to date with screening, and discomfort with stool collection. The authors noted a “mismatch between perceived importance of CRC screening and screening participation.”

Patient preferences also influenced participation. Many respondents expressed a preference for colonoscopy over FIT and raised concerns about test accuracy. Suggested interventions included simpler test kits, additional reminders, and more direct discussion with healthcare providers.

The authors concluded that improving participation may require targeted strategies beyond education alone, including addressing usability and patient preferences.

Reference
Kwon J, Zhou S, Tuan JJ, et al. Addressing fecal immunochemical test underutilization for colorectal cancer screening in Asian Americans: findings from a patient-centered needs assessment. Presented at: Digestive Disease Week; May 2–5, 2026; Chicago, Illinois.