A0172 - Demographic and Socio-Economic Trends in Colon Cancer Screening Rates Among Older Adults in the United States

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

Abel Joseph, MD

Cleveland Clinic Foundation
Cleveland, OH

Abel Joseph, MD¹, Andrew Ford, MD¹, Osama Abushawer, MD²
¹Cleveland Clinic Foundation, Cleveland, OH; ²Cleveland Clinic, Cleveland, OH

Introduction: Colorectal cancer (CRC) screening decreases incidence and improves survival. Screening rates can be influenced by disparities in demographic, social and economic factors. Using a large US database, We aimed to study the demographic and socio-economic factors affecting colon cancer screening rates among older adults.

Methods: We used the Behavior Risk Factor Surveillance System, a nationally representative health-related telephone survey in 2020, to compare reported colorectal cancer screening rates. We included all respondents over the age of 50 eligible for colon cancer screening. We performed binary logistic regression modeling to obtain adjusted odds ratios (aORs) adjusting for race, level of education, health care access limited by insurance coverage and cost. Weighted percentages were calculated as appropriate. Statistical analysis was performed using IBM SPSS version 25, IBM corp.

Results: Of the 401,959 patients surveyed, 132,128 (72.39%) eligible patients had reported undergoing at least one of recommended CRC tests in the appropriate time interval, 43,570 (27.61%) had reported not undergoing any form of screening. Individuals with no cost issues related to access to a doctor in the past year, graduated high school, college attendance and Caucasian had a lower reported risk of lack of CRC screening (aOR 0.729, 0.699, 0.761 p< 0.001; aOR 0.829, 0.788, 0.872 p< 0.001; aOR 0.684, 0.651, 0.720, p< 0.001, aOR 0.731, 0.698, 0.765 p< 0.001 respectively). Individuals without insurance, minority races and females had a higher reported risk of lack of CRC screening (aOR 3.230, 3.082, 3.384 p< 0.001; aOR 1.459, 1.350, 1.576 p< 0.001; aOR 1.084, 1.059, 1.110 p< 0.001 respectively).

Discussion: In this large national survey, we found a modest increase in reported risk of lack of appropriate CRC screening in individuals without insurance, minority groups and females. Individuals with Caucasian race, no cost issues, high school or college education were associated with higher rates of appropriate CRC screening. Further studies on the influence of social determinants of health are required to study its effect on CRC screening rates.

	P value	Adjusted Odds Ratio (aOR)	95% C.I.
	P value	Adjusted Odds Ratio (aOR)	Lower	Upper
No cost issues	< .001	.729	.699	.761
No insurance	.000	3.230	3.082	3.384
Female	< .001	1.084	1.059	1.110
Age 55 to 59	.000	.441	.426	.457
Age 60 to 64	.000	.370	.358	.384
Age 65 to 64	.000	.284	.273	.294
Age 65 to 69	.000	.234	.225	.244
Age 60 to 74	< .001	.260	.241	.281
Graduated high school	< .001	.829	.788	.872
Attended College	< .001	.684	.651	.720
Graduated College	< .001	.535	.509	.563
Caucasian	< .001	.731	.698	.765
African American	< .001	1.459	1.350	1.576
American Indian	< .001	1.295	1.190	1.409
Asian only	.006	1.253	1.068	1.470
Other Race	< .001	1.138	1.056	1.225

Table: Logistic regression Modeling to obtain adjusted odds ratios (aORs) adjusting for race, level of education, health care access limited by insurance coverage and cost

Disclosures:

Abel Joseph indicated no relevant financial relationships.

Andrew Ford indicated no relevant financial relationships.

Osama Abushawer indicated no relevant financial relationships.

Abel Joseph, MD¹, Andrew Ford, MD¹, Osama Abushawer, MD². A0172 - Demographic and Socio-Economic Trends in Colon Cancer Screening Rates Among Older Adults in the United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.