ASPO Abstracts
Does a history of cardiovascular disease affect colorectal cancer screening adherence among different race/ethnic groups?
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose: In patients with cardiovascular disease (CVD), managing their CVD and preventive behaviors like colorectal cancer (CRC) screening are both essential for maintaining overall health, particularly among minorities who are at a higher risk of developing both conditions. The presence of CVD could reduce CRC screening utilization particularly given the complexity of CVD care. We examined whether having CVD is associated with suboptimal CRC screening practices, and whether the association varies by race/ethnicity.Methods: Using the Behavioral Risk Factor Surveillance System (BRFSS) data from 2016, we identified 226,274 US adults aged 50-75 years. CRC screening was categorized as being up-to-date, not-up-to-date, or never screened according to 2018 US Preventive Service Task Force recommendations. Multinomial logistic regression models assessed whether having self-reported CVD was associated with CRC screening practices adjusted for age, sex, race/ethnicity, marital status, binge drinking, smoking, depressive disorder, last time routine check-up, other cancer screening; additional analyses were stratified by race/ethnicity. All analyses were weighted using the recommended BRFSS methodology.Results: One-quarter of US adults had never been screened for CRC regardless of CVD status; rates varied by race/ethnicity: Hispanics (34%), non-Hispanic blacks (23%), and non-Hispanic whites (20%). Relative to those without CVD, participants with CVD were more likely to have suboptimal CRC screening utilization (Never screened adjusted Odds Ratio (aOR): 1.1, 95% Confidence Interval (CI): 1.0-1.2; Not up to date aOR: 1.2, 95% CI: 1.1-1.3). Non-Hispanic blacks with CVD were more likely to not be up-to-date on CRC screening (aOR: 1.2; 95% CI: 0.9-1.7), while non-Hispanics whites with CVD were more likely to have never been screened (aOR:1.1; 95% CI: 1.1-1.2).Conclusion: CRC screening is more often neglected by people with CVD compared to those without CVD, with some variation by race/ethnicity. These findings highlight the need for better understanding of factors that may influence CRC screening utilization among adults with CVD.
Keywords: Colorectal cancer screening, cardiovascular disease, race/ethnicity