Abstract SY30-03: Colorectal cancer screening in underserved populations: COVID, silver linings, and challenges ahead

Abstract

Abstract Colorectal cancer (CRC) screening and appropriate follow-up can reduce incidence and mortality, but screening and abnormal test follow-up rates are suboptimal among medically underserved populations. The United States Preventive Services Task Force (USPSTF) recommends CRC screening through a variety of invasive and noninvasive tests for adults aged 50 to 75 years (grade A) and for individuals aged 45 to 49 years (grade B). Evidence-based interventions and other strategies exist to promote CRC screening, but adoption and implementation of these are limited, especially among medically underserved individuals and those receiving care at community health centers (CHCs) in the United States. Aside from low screening uptake, low colonoscopy follow-up of abnormal stool tests is common in CHCs, estimated to be approximately 50%. Lack of colonoscopy completion for abnormal stool tests defeats the purpose of screening because early-stage cancers go undetected, resulting in higher CRC mortality. Reasons for lack of colonoscopy completion are poorly understood. Cancer screening rates have plummeted as a result of the coronavirus disease 2019 (COVID-19) pandemic, resulting in an estimated 10,000 deaths from breast and CRC alone in the U.S. over the next 10 years. The impact of this drop specific to racial/ethnic groups and communities facing barriers prior to the pandemic is unknown. Prior to the onset of the pandemic, the National Cancer Institute invested in CRC screening research as a result of the Cancer Moonshot’s Blue Ribbon Panel recommendation through its Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science (ACCSIS) initiative. ACCSIS supports research to build the evidence base on multilevel interventions to increase CRC screening, follow-up, and referral to care. Five ACCSIS research projects and a 3-site American Indian project are supported through this initiative, all focusing on underserved populations across the US. This presentation will provide an overview of the key components of the ACCSIS program, challenges faced resulting from the pandemic, and opportunities for overcoming these. In its 2022 report, the President’s Cancer Panel called for equitable cancer screening as a top public health priority. The report emphasizes that overcoming barriers to CRC screening and follow-up among underserved populations must be addressed to ensure that the benefits reach all populations. This provides a timely opportunity to address the extraordinary CRC screening challenges and disparities faced by vulnerable populations. Citation Format: Maria Elena Martinez. Colorectal cancer screening in underserved populations: COVID, silver linings, and challenges ahead [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr SY30-03.