2834 Sex, Cancer Survivorship, and Colorectal Cancer Screening Among U.S. Adults: Analysis of a National Survey

Abstract

INTRODUCTION: Men suffer higher burden from colorectal cancer (CRC) when compared to women. It is uncertain if this is due to poorer health services utilization or biological differences. It is well established that patients become more health conscious after a cancer diagnosis “as a wake-up call”. Aim: To determine uptake of CRC screening (with fecal occult blood test or endoscopy) among adult men and women in the United States and evaluate whether screening uptake differs by sex after a diagnosis of any cancer. METHODS: Methods: We used the 2013 Health Information National Trends Survey (HINTS) 4 cycle 3 conducted by the National Cancer Institute. A total of 1,829 respondents (weighted population size = 90,313,161) were 50 years and older. There were 732 (45.9%) men (weighted population size = 41,452,732) and 1,097 (54.1%) women (weighted population size = 48,860,429). There were 356 (14.7%) cancer survivors (weighted population size = 13,267,800) and 1,473 (85.3%) (weighted population size = 77,045,361) without any history of cancer. We evaluated whether survey respondents were ever screened for CRC (with fecal occult blood test or endoscopy) and compared CRC screening by cancer survivorship among men and women. All percentages were weighted. RESULTS: Overall, there were no sex differences in CRC screening rates among respondents (70.5% versus 75.2%; OR = 0.79; 95% CI: 0.58-1.07; P value = 0.13) regardless of cancer status. However, cancer survivors had increased CRC screening uptake (85.5% versus 70.5%: OR = 2.48; 95% CI: 1.46-4.22; P value = 0.001) regardless of sex in unadjusted analysis. Although there was an absolute 20.2% increase in CRC screening among men and an absolute 11.7% increase in CRC screening among women who have been diagnosed with a cancer, the differences were not statistically significant after adjustment for healthcare insurance status (Table 1). CONCLUSION: Conclusion: Increased efforts should be made to improve CRC prevention education and healthcare insurance coverage of US adults.