Impact of Diabetes on Colorectal Cancer Screening Rates in U.S. Adults

Abstract

Background: Individuals with diabetes have an increased risk for colorectal cancer, however routine diabetes care visits may increase colorectal screening rates. The aim of this study is to examine whether diabetes diagnosis influences screening completion in U.S. adults. Methods: This study used data from 464,664 adults completing the 2014 BRFSS national survey. Logistic regression models tested the likelihood of colorectal screening by diabetes status, and whether diabetes quality of care indicators predicted colorectal screening among diabetes patients. A stratified analysis examined predictors of screening by demographic status for diabetes/nondiabetes patients. Result: Of the population, 13.1% reported having diabetes and of these, 67% reported completing colorectal screening. Diabetes status, accounting for demographic variables, predicted blood stool screening in the last year (OR 1.09), colonoscopy (OR 1.17), and any colorectal screening technique (OR 1.08). For diabetes patients, non-Hispanic black patients were significantly more likely to receive any type of screening (OR 1.18), as well as women (OR 1.15). Diabetes patients reporting an HbA1c check (OR 1.49), having their eyes checked (OR 1.52), and receiving diabetes education (OR 1.37) were significantly more likely to have completed any screening technique, whereas primary care visits did not predict screening. Conclusions: Patients with diabetes are more likely to complete colorectal screening compared to patients without diabetes. Non-Hispanic blacks and women with diabetes were significantly more likely to complete any screening, whereas this was not the case in patients with no diabetes. Quality of care indicators and receiving diabetes education significantly predicted screening completion compared to having a physician visit alone. Colorectal screening interventions incorporating patient engagement may be warranted for both the diabetes and general population. Disclosure J.A. Campbell: None. R.J. Walker: None. C. Eiler: None. L.E. Egede: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. Advisory Panel; Self; Novo Nordisk Inc..