OBJECTIVES:

Colorectal cancer (CRC) is the second leading cause of cancer death among women and men, with an estimate of over 130,000 new cases and 50,000 deaths annually. The United States Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer from 50 years and continuing until 75 years. This study aims to evaluate whether disparity in colorectal cancer screening exist among veterans in the US using a large, nationally-representative dataset.

METHODS:

Cross-sectional data from Behavioral Risk Factor Surveillance System (BRFSS) 2014 - 2016 was pooled for this study. Participants were restricted to veterans aged 50 -75 to accommodate USPSTF guideline. Multivariate logistic regression models were used to estimate relevant parameters. All analyses were conducted using STATA version 15.1.

RESULTS:

Out of 389,479 veterans, only 71,577 (18.4%) had CRC screening. Veterans who identified themselves as Blacks [OR, 1.18 (95% CI: 1.15 – 1.21)], married [OR, 1.25 (95% CI: 1.22 - 1.29)], and aged 65 years and older [OR, 4.69 (95% CI: 4.58 - 4.81)], had higher odds of screening for CRC. In contrast, female veterans [OR, 0.80 (95% CI: 0.79 - 0.81)], had lower odds of screening for CRC compared to male veterans. Hispanic veterans [OR, 0.73 (95% CI: 0.71 - 0.76)], and those from other ethnicity [OR, 0.74 (95% CI: 0.72 - 0.77)], had lower odds of screening for CRC compared to Whites.

CONCLUSIONS:

Our findings highlight the need for strategies to improve CRC screening among female and Hispanic veterans in order to reduce disparities that exist. Future studies should focus on plans to increase CRC screening in disadvantaged populations with lowest screening rates in order to achieve the 80% national target.