Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Ave North, Worcester, MA 01655 (
Division of Health Systems Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
Prev Chronic Dis. 2024 Feb 22;21:E12. doi: 10.5888/pcd21.230257.
People with chronic conditions and people with colorectal cancer (CRC) may share common risk factors; thus, CRC screening is important for people with chronic conditions. We examined racial and ethnic differences in the use of CRC screening among people with various numbers of chronic conditions.
We included data on adult respondents aged 50 to 75 years from the Behavioral Risk Factor Surveillance System in 2012 through 2020. We categorized counts of 9 conditions as 0, 1, 2, 3, and ≥4. We classified self-reported CRC screening status as up to date or not. We used Poisson models to estimate adjusted prevalence ratios (APRs) among the different counts of chronic conditions in 4 racial and ethnic groups: Hispanic adults with limited English proficiency (LEP), Hispanic adults without LEP, non-Hispanic Black adults, and non-Hispanic White adults.
Overall, 66.5% of respondents were up to date with CRC screening. The prevalence of being up to date increased with the number of chronic conditions. We found disparities among racial and ethnic groups. Hispanic respondents with LEP had lower rates than non-Hispanic White adults of being up to date with CRC screening across all counts of chronic conditions (APR for 0 conditions = 0.67; 95% CI, 0.64-0.71; APR for ≥4 conditions = 0.85; 95% CI, 0.79-0.91). Hispanic respondents without LEP with 0, 1, or 2 conditions were less likely than non-Hispanic White respondents to be up to date with CRC screening. We found no significant differences between non-Hispanic Black and non-Hispanic White respondents.
We found disparities among Hispanic BRFSS respondents with LEP, who had lower rates than non-Hispanic White respondents of being up to date with CRC screening, regardless of the number of chronic conditions. Tailored interventions are needed to address these disparities and improve screening rates, particularly among Hispanic people.
患有慢性病和结直肠癌（CRC）的人群可能具有共同的风险因素；因此，CRC 筛查对患有慢性病的人群很重要。我们研究了具有不同数量慢性病的人群中 CRC 筛查的使用情况在不同种族和族裔之间的差异。
我们纳入了 2012 年至 2020 年行为风险因素监测系统中 50 至 75 岁成年受访者的数据。我们将 9 种疾病的数量分类为 0、1、2、3 和≥4。我们将自我报告的 CRC 筛查状况分为最新或不最新。我们使用泊松模型估计了在 4 个种族和族裔群体中不同数量慢性疾病的调整后患病率比（APR）：英语水平有限的西班牙裔成年人（LEP）、英语水平无限制的西班牙裔成年人、非西班牙裔黑人和非西班牙裔白人成年人。
总体而言，66.5%的受访者接受了 CRC 筛查。随着慢性病数量的增加，最新筛查的比例也在增加。我们发现了不同种族和族裔群体之间的差异。在所有慢性病计数中，英语水平有限的西班牙裔受访者的 CRC 筛查最新率低于非西班牙裔白人成年人（0 个条件的 APR 为 0.67；95%CI，0.64-0.71；≥4 个条件的 APR 为 0.85；95%CI，0.79-0.91）。有 0、1 或 2 种疾病的英语水平无限制的西班牙裔受访者比非西班牙裔白人受访者更不可能接受 CRC 筛查。我们没有发现非西班牙裔黑人和非西班牙裔白人受访者之间存在显著差异。
我们发现英语水平有限的西班牙裔 BRFSS 受访者存在差异，无论慢性病数量如何，他们接受 CRC 筛查的最新率都低于非西班牙裔白人受访者。需要有针对性的干预措施来解决这些差异并提高筛查率，特别是在西班牙裔人群中。
