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The relationship of cancer history and chronic disease status to colorectal cancer screening: A cross-sectional analysis of 2020–2021 Behavioral Risk Factor Surveillance System

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Abstract

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.

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Data availability

The datasets generated during the current study are available in the Center for Disease Control, and Prevention repository, https://www.cdc.gov/brfss/.

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Acknowledgments

Thanks to co-authors for their expertise and assistance throughout all aspects of this study and for their help in completing the manuscript.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA

    Meng-Han Tsai

  2. Georgia Prevention Institute, Augusta University, 1120 15Th Street, HS-1705, Augusta, GA, 30912, USA

    Meng-Han Tsai

  3. Department of Public Health, California State University, Fullerton, Fullerton, CA, USA

    Alice W. Lee

  4. Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA

    Minjee Lee

  5. Simmons Cancer Institute at Southern Illinois University School of Medicine, Springfield, IL, USA

    Minjee Lee

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Contributions

M-HT and AWL. contributed to the study conception and design. Material preparation, data collection and analysis were performed by M-HT. The first draft of the manuscript was written by all authors and everyone commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Meng-Han Tsai.

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Competing interests

The authors declare no potential conflict of interest.

Ethical approval

The respective health departments from each state grant Institutional Review Board (IRB) approval for the distribution and collection of data using the BRFSS. Data extracted for this study were publicly available and de-identified, and thus considered exempt from IRB review at Augusta University. This article does not include any studies with animals performed by any of the authors.

Consent to participate

Verbal informed consent was obtained from all individual participants included in the study as per the BRFSS process for data collection.

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This study does not include any individual person’s data in any form (including any individual details, images, or videos).

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Tsai, MH., Lee, A.W. & Lee, M. The relationship of cancer history and chronic disease status to colorectal cancer screening: A cross-sectional analysis of 2020–2021 Behavioral Risk Factor Surveillance System. Cancer Causes Control 35, 623–633 (2024). https://doi.org/10.1007/s10552-023-01820-w

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