Purpose

We examined whether having a history of cancer and chronic diseases was associated with guideline-concordant colorectal cancer (CRC) screening utilization.

Methods

Self-reported data from the 2020 and 2021 Behavioral Risk Factor Surveillance System in Oregon and West Virginia were used. Guideline-concordant CRC screening was the outcome of interest. The exposure was having a personal history of cancer, chronic diseases, or both. Multivariable logistic regressions were applied to assess the abovementioned association.

Results

Among 10,373 respondents aged 45–75 years, 75.5% of those with a history of cancer and chronic diseases had guideline-concordant CRC screening use versus 52.8% of those without any history (p-value < 0.05). In multivariable analysis, having a history of cancer (OR 1.74; 95% CI 1.11–2.71), chronic diseases (OR 1.35; 95% CI 1.14–1.59), and both cancer and chronic diseases (OR 2.14; 95% CI 1.62–2.82) were positively associated with screening uptake compared to respondents without any history. Regardless of disease history, older age was associated with greater CRC screening uptake (p-value < 0.05). Among respondents with chronic diseases only or without any condition, those with a health care provider had 1.7-fold and 2.7-fold increased odds of receiving CRC screening, respectively. However, current smokers were 28% and 34% less likely to be screened for CRC among those with chronic diseases only and without any conditions, respectively.

Conclusion

Having a personal history of cancer and chronic diseases appears to be positively associated with guideline-concordant CRC screening use. Effective implementation of patient-centered communication through primary care initiatives may increase adherence to CRC screening recommendations.

中文翻译：

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癌症病史和慢性病状况与结直肠癌筛查的关系：2020-2021年行为危险因素监测系统的横断面分析

目的

我们检查了癌症和慢性病史是否与符合指南的结直肠癌 (CRC) 筛查利用相关。

方法

使用了俄勒冈州和西弗吉尼亚州 2020 年和 2021 年行为风险因素监测系统的自我报告数据。符合指南的 CRC 筛查是令人感兴趣的结果。接触者有癌症、慢性病或两者兼而有之的个人病史。应用多变量逻辑回归来评估上述关联。

结果

在 10,373 名年龄 45-75 岁的受访者中，75.5% 有癌症和慢性病史的人使用了符合指南的 CRC 筛查，而没有任何病史的人则为 52.8%（p值 < 0.05）。在多变量分析中，有癌症病史（OR 1.74; 95% CI 1.11–2.71）、慢性病史（OR 1.35; 95% CI 1.14–1.59）以及癌症和慢性病史（OR 2.14; 95% CI 1.62– 2.82）与没有任何病史的受访者相比与筛查率呈正相关。无论疾病史如何，年龄越大，CRC 筛查率越高（p值 < 0.05）。在仅患有慢性疾病或没有任何疾病的受访者中，有医疗保健提供者的受访者接受 CRC 筛查的几率分别增加了 1.7 倍和 2.7 倍。然而，目前吸烟者在仅有慢性病和无任何疾病的人群中接受 CRC 筛查的可能性分别降低了 28% 和 34%。

结论

有癌症和慢性病的个人病史似乎与符合指南的 CRC 筛查使用呈正相关。通过初级保健举措有效实施以患者为中心的沟通可能会提高对 CRC 筛查建议的遵守率。