Abstract
INTRODUCTION: Colorectal cancer (CRC) is a leading cause of cancer death among Hispanic Americans. Puerto Ricans are the second largest Hispanic subgroup in the United States and the largest in New York City, but little is known about predictors of CRC screening uptake in this population. We used the New York City Community Health Survey (NYCCHS), a population-based telephone survey, to investigate predictors of up-to-date colonoscopy use over time among Puerto Ricans aged ≥50 in NYC. METHODS: We assessed the association between sociodemographic and medical factors and up-to-date colonoscopy use (defined as colonoscopy in the last 10 years) over four time periods: 2003-2008, 2009-2012, 2013-2014, and 2015-2016. We entered age, sex, and any additional factors with P < 0.10 on univariate analysis into a multivariable model and reached the final model for each period using stepwise backward selection. RESULTS: On univariate analysis, factors including age ≥65, having a primary care provider, and receiving the flu shot were associated with colonoscopy use in the last 10 years. After adjusting for multiple sociodemographic and medical factors (Table 1), age ≥65 [OR 1.41 (2003-2008), OR 1.76 (2013-2014), OR 1.82 (2015-2016)] and receiving the flu shot [OR 2.14 (2003-2008), OR 1.52 (2009-2012), OR 1.95 (2013-2014), OR 1.62 (2015-2016)] were two factors positively associated with up-to-date colonoscopy use over most time periods. Those without a primary care provider [OR 0.53 (2003-2008), OR 0.38 (2013-2014)] were significantly less likely to have an up-to-date colonoscopy. CONCLUSION: Older age, having a primary care provider, and receiving the flu shot are independent predictors of up-to-date colonoscopy use among Puerto Ricans in NYC. Targeted interventions to improve CRC screening should be considered for Puerto Ricans aged 50-64 and those who do not have a primary care provider.
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