Disparities in Colorectal Cancer Screening

Patients with more comorbidities are less likely to be screened for colorectal cancer (CRC), according to the results of a recent study.

A cross sectional analysis was conducted to better understand how the presence of comorbidities impacted screening efforts for CRC. The researchers utilized data from the 2018 and 2019 Behavioral Risk Surveillance System including 279,784 adults. All respondents were aged 50 years or older.

The results indicated that 79.7% of eligible adults had received CRC screening, which was defined here as having answered yes when asked if they had ever had a blood stool test or sigmoidoscopy/colonoscopy.

Patients with comorbidities were more likely to be screened than those without comorbidities. However, individuals with 1 comorbidity were significantly more likely to be screened than those with 2 to 4 comorbidities. Individuals with 2 to 4 comorbidities were also significantly more likely to be screened than those with 5 or more comorbidities.

Specifically, diabetes, hypertension, skin cancer, chronic obstructive pulmonary disease, arthritis, depression, and chronic kidney disease were among the conditions associated with higher rates of screening. Screening rates among those with and without cardiovascular disease showed no significant difference.

“Patients with 1 or more comorbidities were more likely to be screened than those without comorbidities, but those with 5 or more conditions were less likely to be screened than patients with 2 to 4 conditions. This indicates that physicians may be more fatigued and less likely to recommend CRC screening to patients with many comorbidities compared with patients diagnosed with only a few conditions,” the researchers concluded. “The results of this study add to the literature by identifying an interaction between the number of comorbidities and likelihood of being screened for CRC.”

—Leigh Precopio

Reference:

Greiner B, Gandhi R, Abrol R, Patel M, Hartwell M. National disparities in colorectal cancer screening in patients with comorbid conditions: an analysis of the Behavioral Risk Factor Surveillance System. J Osteopath Med. Published online April 23, 2021. https://pubmed.ncbi.nlm.nih.gov/33892528/