Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Cancer Causes Control. 2024 Dec;35(12):1565-1572. doi: 10.1007/s10552-024-01915-y. Epub 2024 Sep 14.
To assess the association between food insecurity and colorectal cancer screening uptake in screening eligible participants in New York State.
We analyzed 28,154 adults who participated in New York State Behavioral Risk Factor Surveillance System (BRFSS) from 2018 to 2021, were age-eligible for colorectal cancer screening based on the USPSTF guidelines at the time of survey administration and answered a version of the administered survey that included the module on food insecurity. Participants were defined as food insecure if they self-reported being always, usually, or sometimes stressed about having enough money to buy nutritious meals in the past 12 months. We compared demographic, healthcare access, overall health status, food insecurity by colorectal cancer screening status. Multivariable analyses were performed to assess the association of food insecurity and colorectal cancer screening status after adjusting for relevant covariates. Weighted analyses were performed using survey procedures to obtain population estimates.
Food insecurity was statistically significantly associated a decreased likelihood of being up to date on colorectal cancer screening (OR 0.83, 95% CI [0.72, 0.94]) and being ever screened for colorectal cancer (OR 0.74, 95% CI [0.64, 0.87]) after adjusting for overall health status, healthcare coverage, interview year, age, race/ethnicity, sex, educational attainment, and income. Health status, health coverage, age, and Non-Hispanic Black race/ethnicity showed positive, statistically significant association with ever being screened and with being up to date for colorectal cancer screening. Lower income, lower educational attainment, and non-Hispanic Asian race/ethnicity were statistically significant inverse predictors of ever being screened and being up to date on screening.
This project assessed the association between food insecurity and colorectal cancer screening uptake using the BRFSS survey. Food insecurity may be an important predictor for colorectal cancer screening uptake in eligible adults in the United States. The results from the study can inform future interventions and policies designed to improve participation in routine colorectal cancer screening.
评估在纽约州符合筛查条件的参与者中，食物不安全与结直肠癌筛查参与率之间的关联。
我们分析了 2018 年至 2021 年期间参加纽约州行为风险因素监测系统（BRFSS）的 28154 名成年人，他们在接受调查时根据 USPSTF 指南达到结直肠癌筛查的年龄要求，并回答了经过修订的调查版本，其中包括关于食物不安全的模块。如果参与者在过去 12 个月中自我报告经常、通常或有时因担心没有足够的钱购买营养膳食而感到压力，则被定义为食物不安全。我们比较了人口统计学特征、医疗保健可及性、总体健康状况、按结直肠癌筛查状况划分的食物不安全情况。在调整相关协变量后，进行多变量分析以评估食物不安全与结直肠癌筛查状况之间的关联。使用调查程序进行加权分析，以获得人口估计值。
在调整总体健康状况、医疗保健覆盖范围、访谈年份、年龄、种族/族裔、性别、教育程度和收入后，食物不安全与结直肠癌筛查不及时（OR 0.83，95%CI [0.72, 0.94]）和从未接受过结直肠癌筛查（OR 0.74，95%CI [0.64, 0.87]）的可能性呈统计学显著负相关。健康状况、健康覆盖范围、年龄和非西班牙裔黑人种族/族裔与曾接受过筛查和及时进行结直肠癌筛查呈正相关，具有统计学意义。较低的收入、较低的教育程度和非西班牙裔亚裔种族/族裔是曾接受过筛查和及时进行筛查的统计学显著负预测因素。
本项目使用 BRFSS 调查评估了食物不安全与结直肠癌筛查参与率之间的关联。食物不安全可能是美国符合条件的成年人结直肠癌筛查参与率的一个重要预测因素。该研究结果可为旨在提高常规结直肠癌筛查参与率的未来干预措施和政策提供信息。
