Colon cancer screening among respondents of the 2021 Behavioral Risk Factors Surveillance Survey
Location
Culp Center Rm. 217
Start Date
4-25-2023 1:40 PM
End Date
4-25-2023 2:00 PM
Faculty Sponsor’s Department
Health Services Management & Policy
Name of Project's Faculty Sponsor
Nathan Hale
Competition Type
Competitive
Type
Oral Presentation
Project's Category
Cancer or Carcinogenesis, Public Health
Abstract or Artist's Statement
In 2019, cancer was the second leading cause of death in the United States. Colorectal cancer is the second most common cancer affecting both men and women. Colorectal screenings are an important preventive health service, with approximately half of cases detected through screening, improving life expectancy among those diagnosed. Previous research has noted differences in screening rates between racial or ethnic groups, with whites being screened at a higher rate than other racial and ethnic groups. Additionally, the prevalence of colorectal cancer is becoming more common among persons younger than 50 years old, prompting testing guidelines to be revised in 2018 that call for testing to begin at 45 instead of age 50. The purpose of this analysis is to investigate this issue further by examining differences in colorectal screening among various racial and ethnic groups.
A cross-sectional study using the 2021 Behavioral Risk Factor Surveillance System for respondents from West Virginia and Oregon (combined) was used to examine colon cancer screening by various racial and ethnic populations. Individuals responding receipt of a colonoscopy or sigmoidoscopy were the primary outcome of interest. Racial and ethnic groups include whites-only, blacks-only, other races, multi-racial and those of Hispanic ethnicity. Additional covariates of interest were included in the analysis based on Andersen’s behavior model for health service utilization and includes predisposing (gender, age, education, marital status) enabling (insurance, employment status) need (body mass index, other types of cancers) factors. Bivariate and multivariate logistic regression analysis was used to examine these relationships.
The study population included 2,831 adults who self-reported being screened for colon cancer. Overall 61% of white populations reported receipt of colon cancer screening compared to 54% of Black, 52% of Other, and 43% of Hispanic populations (p<0.00). Adjusting for additional covariates of interest, there were no significant differences between colon cancer screening among black populations compared to their white counterparts (aOR=.81; 95% CI=0.40-1.64). Age and education independently predicted being screened for colon cancer. Graduating from college increased an individual’s odds of being screened for colon cancer (OR= 2.1, 95% CI: 1.1-4.0). The odds also increased for individuals between the age of 55 to 64 (OR=4.2, 95% CI: 3.2-5.3) and ages 65 to 74 (OR=10.0, 95% CI: 6.8-14.8).
Our study did not find significant differences in colon cancer screening by race/ethnicity in these two states. It is possible the racial and ethnic composition of the states contributed to the observed findings. West Virginia and Oregon are predominantly white. Smaller subpopulation groups within the national BRFSS dataset may not be sufficient to detect important differences in screenings. Furthermore, it is possible that several factors associated with screening (age, education) may be associated with race/ethnicity but are stronger predictors than race/ethnicity itself. Regular screening for colorectal cancer can help with detecting and treating colon cancer. Additional efforts to increase the general knowledge of colorectal cancer risks should be encouraged for individuals who did not graduate from college and are between 45 to 55 years old.
Colon cancer screening among respondents of the 2021 Behavioral Risk Factors Surveillance Survey
Culp Center Rm. 217
In 2019, cancer was the second leading cause of death in the United States. Colorectal cancer is the second most common cancer affecting both men and women. Colorectal screenings are an important preventive health service, with approximately half of cases detected through screening, improving life expectancy among those diagnosed. Previous research has noted differences in screening rates between racial or ethnic groups, with whites being screened at a higher rate than other racial and ethnic groups. Additionally, the prevalence of colorectal cancer is becoming more common among persons younger than 50 years old, prompting testing guidelines to be revised in 2018 that call for testing to begin at 45 instead of age 50. The purpose of this analysis is to investigate this issue further by examining differences in colorectal screening among various racial and ethnic groups.
A cross-sectional study using the 2021 Behavioral Risk Factor Surveillance System for respondents from West Virginia and Oregon (combined) was used to examine colon cancer screening by various racial and ethnic populations. Individuals responding receipt of a colonoscopy or sigmoidoscopy were the primary outcome of interest. Racial and ethnic groups include whites-only, blacks-only, other races, multi-racial and those of Hispanic ethnicity. Additional covariates of interest were included in the analysis based on Andersen’s behavior model for health service utilization and includes predisposing (gender, age, education, marital status) enabling (insurance, employment status) need (body mass index, other types of cancers) factors. Bivariate and multivariate logistic regression analysis was used to examine these relationships.
The study population included 2,831 adults who self-reported being screened for colon cancer. Overall 61% of white populations reported receipt of colon cancer screening compared to 54% of Black, 52% of Other, and 43% of Hispanic populations (p<0.00). Adjusting for additional covariates of interest, there were no significant differences between colon cancer screening among black populations compared to their white counterparts (aOR=.81; 95% CI=0.40-1.64). Age and education independently predicted being screened for colon cancer. Graduating from college increased an individual’s odds of being screened for colon cancer (OR= 2.1, 95% CI: 1.1-4.0). The odds also increased for individuals between the age of 55 to 64 (OR=4.2, 95% CI: 3.2-5.3) and ages 65 to 74 (OR=10.0, 95% CI: 6.8-14.8).
Our study did not find significant differences in colon cancer screening by race/ethnicity in these two states. It is possible the racial and ethnic composition of the states contributed to the observed findings. West Virginia and Oregon are predominantly white. Smaller subpopulation groups within the national BRFSS dataset may not be sufficient to detect important differences in screenings. Furthermore, it is possible that several factors associated with screening (age, education) may be associated with race/ethnicity but are stronger predictors than race/ethnicity itself. Regular screening for colorectal cancer can help with detecting and treating colon cancer. Additional efforts to increase the general knowledge of colorectal cancer risks should be encouraged for individuals who did not graduate from college and are between 45 to 55 years old.