OBJECTIVES: To assess preferences for colorectal cancer (CRC) screening in a diverse patient population through a series of focus groups. METHODS: This project used a qualitative research design involving focus groups to derive patient perceptions of CRC screening, including their motivators and barriers, and from this information derive personalized preferences for this screening using adaptive choice-based conjoint analysis techniques. Focus groups were defined by race/ethnicity and sex. Participants under the age of 50 were recruited from the internal medicine clinics at the Greenville Health System (GHS) because screening guidelines specify that CRC screening should begin at the age of 50, and we were interested in understanding screening decisions being made for the future. RESULTS: A total of 10 participants were interviewed across 4 focus groups. Awareness about CRC itself was low and limited to information from survivors or family history of CRC. Those who had heard about screening had only heard about colonoscopy as a possible screening modality. Most participants believed that cancer was a serious condition. While women were more concerned about their health in general and seemed to take a proactive approach to learning about their health, men seemed to consider screening if/when their doctor suggested it. Lack of transportation, cost, the invasive nature of the test, fear and struggling to decipher the information were the main concerns shared by the participants. To overcome these barriers participants stated that they wanted more education about the cancer itself and how it affects the body so that they may know when the best time to be screened was and what symptoms to look for after that. Participants also believed that much of the fears could be overcome by educating patients about screening using non-technical language. CONCLUSIONS: Fear of screening consistently emerged as a significant factor, detering patients from getting screened. Helping patients alleviate their fears through education may encourage CRC screening.