Sequeira Lynette, Vaidya Dhananjay, Ma Jianqiao, Bansal Aarav, Huang Shanshan, Nimgaonkar Ashish, Gupta Ekta
Department of Internal Medicine 1, School of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA.
Department of Gastroenterology and Hepatology, School of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA.
Cancers (Basel). 2025 May 16;17(10):1686. doi: 10.3390/cancers17101686.
Colorectal cancer (CRC) continues to impart a significant mortality burden in the United States, with a growing number of cases affecting younger individuals. In this study, we set out to characterize predictors of missed colorectal cancer screening in a general and age-stratified population. : We analyzed a patient population of over 85,000 patients who presented to a large outpatient network in the Baltimore, Maryland area and were due for CRC screening. We analyzed different characteristics, including race, occupation, relationship status, tobacco smoking status, and body mass index, of patients up to date and overdue on their CRC screening. The majority (over 99%) of our patient population was insured. We performed this analysis on the patient population as a whole and as an age-stratified patient population. : In our overall patient population, all of the aforementioned characteristics were significantly different between patients up to date and those overdue on CRC screening. Races with the highest up-to-date CRC screening proportion were Pacific Islanders, East Asian, and White patients, while Asian Indian patients had the lowest up-to-date percentage. Non-employed patients (including patients with disabilities and students), single patients, and current or past tobacco smokers were all found to have significantly lower percentages of up-to-date patients as compared to other groups within these categories. BMI was significantly lower in up-to-date patients. In our age-stratified analysis, younger patients had a significantly lower percentage of up-to-date patients. Notably, younger patients had a significantly higher proportion of patients electing for noninvasive screening modalities. : These disparities in CRC screening warrant targeted interventions to minimize future risk of heightened mortality in certain patient populations.
在美国,结直肠癌(CRC)仍然造成巨大的死亡负担,且影响年轻个体的病例数量不断增加。在本研究中,我们旨在确定普通人群和按年龄分层的人群中结直肠癌筛查遗漏的预测因素。:我们分析了超过85000名患者的群体,这些患者前往马里兰州巴尔的摩地区的一个大型门诊网络就诊,且应进行CRC筛查。我们分析了已按时和逾期进行CRC筛查的患者的不同特征,包括种族、职业、婚姻状况、吸烟状况和体重指数。我们的患者群体中大多数(超过99%)有保险。我们对整个患者群体以及按年龄分层的患者群体进行了此项分析。:在我们的整个患者群体中,上述所有特征在已按时进行CRC筛查的患者和逾期未筛查的患者之间存在显著差异。按时进行CRC筛查比例最高的种族是太平洋岛民、东亚人和白人患者,而印度裔患者的按时筛查比例最低。与这些类别中的其他群体相比,未就业患者(包括残疾患者和学生)、单身患者以及目前或过去的吸烟者按时进行筛查的患者比例均显著较低。按时进行筛查的患者的体重指数显著较低。在我们按年龄分层的分析中,年轻患者按时进行筛查的比例显著较低。值得注意的是,年轻患者选择非侵入性筛查方式的比例显著较高。:CRC筛查中的这些差异需要有针对性的干预措施,以尽量降低某些患者群体未来死亡率升高的风险。