SOCIO-DEMOGRAPHIC FACTORS AND ADHERENCE TO COLORECTAL CANCER SCREENING GUIDELINES IN THE UNITED STATES: EVIDENCE FROM BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA
Author(s)
Kumar Mukherjee, PhD1, Elizabeth Unni, MBA, PhD2;
1Touro University College of Pharmacy, New York, NY, USA, 2Touro College of Pharmacy, New York, NY, USA
1Touro University College of Pharmacy, New York, NY, USA, 2Touro College of Pharmacy, New York, NY, USA
OBJECTIVES: In 2021, the United States Preventive Services Taskforce updated colorectal cancer (CRC) screening guidelines including adults between 45-49 years. This research aims to measure adherence to CRC screening guidelines and explore association between socio-demographic characteristics and non-adherence in a nationally representative sample of 45 years and older.
METHODS: This retrospective, cross-sectional study analyzed 2022 and 2024 Behavioral Risk Factor Surveillance System (BRFSS) data. Adherence to screening guidelines was defined as having at least one of the recommended CRC tests within the recommended time interval. Non-adherence was defined as not having any of the recommended CRC tests within the recommended time interval or never having those. Survey-weighted multivariable logistic regression was used to explore association between socio-demographic characteristics and screening adherence.
RESULTS: A total of 449738 individuals, representing a weighted sample of 214809978 US adults were eligible for CRC screening (51.20% female; mean [SD] age, 59.73 [8.63] years). Among them,126994 (weighted 68268809), 31.78% were non-adherent to screening guidelines. Among non-adherents, 51.39% male, 29.70% between 45-49 years old, 57.25% non-Hispanic white, 49.19% had private and 13.93% had no insurance, 56.65% attended or graduated from college,14.76% could not afford to see a doctor in past 12 months. Odds of non-adherence increased for uninsured compared to private insurance (Odds ratio (OR)= 2.72 (95%CI:2.52-2.94)), those can’t afford to see doctor (OR=1.59 (95%CI:1.49-1.69)), younger age (45-49 vs. >=65 years: OR=7.66 (95%CI:7.24-8.09); 50-64 vs. >=65 years: OR=1.94 (95%CI:1.86-2.02), less educated (did not graduate high school: OR=2.20 (95% CI:2.05-2.35); graduated high school: OR=1.58 (95%CI: 1.51-1.65) compared to college graduates).
CONCLUSIONS: Using nationally representative data this study highlights a substantial portion of eligible population was not adherent to CRC screening guidelines, especially those with lack of insurance and affordability, less education, and at younger age of screening eligibility. Targeted intervention to specific groups may increase adherence to CRC screening guidelines.
METHODS: This retrospective, cross-sectional study analyzed 2022 and 2024 Behavioral Risk Factor Surveillance System (BRFSS) data. Adherence to screening guidelines was defined as having at least one of the recommended CRC tests within the recommended time interval. Non-adherence was defined as not having any of the recommended CRC tests within the recommended time interval or never having those. Survey-weighted multivariable logistic regression was used to explore association between socio-demographic characteristics and screening adherence.
RESULTS: A total of 449738 individuals, representing a weighted sample of 214809978 US adults were eligible for CRC screening (51.20% female; mean [SD] age, 59.73 [8.63] years). Among them,126994 (weighted 68268809), 31.78% were non-adherent to screening guidelines. Among non-adherents, 51.39% male, 29.70% between 45-49 years old, 57.25% non-Hispanic white, 49.19% had private and 13.93% had no insurance, 56.65% attended or graduated from college,14.76% could not afford to see a doctor in past 12 months. Odds of non-adherence increased for uninsured compared to private insurance (Odds ratio (OR)= 2.72 (95%CI:2.52-2.94)), those can’t afford to see doctor (OR=1.59 (95%CI:1.49-1.69)), younger age (45-49 vs. >=65 years: OR=7.66 (95%CI:7.24-8.09); 50-64 vs. >=65 years: OR=1.94 (95%CI:1.86-2.02), less educated (did not graduate high school: OR=2.20 (95% CI:2.05-2.35); graduated high school: OR=1.58 (95%CI: 1.51-1.65) compared to college graduates).
CONCLUSIONS: Using nationally representative data this study highlights a substantial portion of eligible population was not adherent to CRC screening guidelines, especially those with lack of insurance and affordability, less education, and at younger age of screening eligibility. Targeted intervention to specific groups may increase adherence to CRC screening guidelines.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO26
Topic
Clinical Outcomes
Topic Subcategory
Performance-based Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology