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. 2018 Jun 19:8:230.
doi: 10.3389/fonc.2018.00230. eCollection 2018.

Predictors of Colorectal Cancer Screening in Two Underserved U.S. Populations: A Parallel Analysis

Brittany M Bernardo  1 , Amy L Gross  2 , Gregory Young  3 , Ryan Baltic  1 , Sarah Reisinger  1 , William J Blot  2   4 , Electra Diane Paskett  1   5   6
Affiliations

Predictors of Colorectal Cancer Screening in Two Underserved U.S. Populations: A Parallel Analysis

Brittany M Bernardo et al. Front Oncol. .

Abstract

Background: Despite declining colorectal cancer (CRC) incidence and mortality rates in the U.S., significant geographic and racial disparities in CRC death rates remain. Differences in guideline-concordant CRC screening rates may explain some of these disparities. We aim to assess individual and neighborhood-level predictors of guideline-concordant CRC screening within two cohorts of individuals located within CRC mortality geographic hotspot regions in the U.S.

Methods: A total of 36,901 participants from the Southern Community Cohort Study and 4,491 participants from the Ohio Appalachia CRC screening study were included in this study. Self-reported date of last CRC screening was used to determine if the participant was within guidelines for screening. Logistic regression models were utilized to determine the association of individual-level predictors, neighborhood deprivation, and residence in hotspot regions on the odds of being within guidelines for CRC screening.

Results: Lower household income, lack of health insurance, and being a smoker were each associated with lower odds of being within guidelines for CRC screening in both cohorts. Area-level associations were less evident, although up to 15% lower guideline adherence was associated with residence in neighborhoods of greater deprivation and in the Lower Mississippi Delta, one of the identified CRC mortality hotspots.

Conclusion: These results reveal the adverse effects of lower area-level and individual socioeconomic status on adherence to CRC guideline screening.

Keywords: correlates of screening; guideline colorectal cancer screening; guideline screening; neighborhood deprivation; underserved populations.

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