The Association Between Education and Colorectal Cancer Screening among United States Veterans Aged 50-75 Years Old

Abstract

Introduction: Colorectal cancer (CRC) is the third most common cause of cancer in the United States (US) and represents 9% of all cancers within the Veteran Health Administration. CRC screening (CRCS) is recommended between ages 50-75. There is a paucity of data on the predictors of CRCS among veterans. This study examines the association between education and CRCS among US veterans 50-75 years old. Methods: The 2012 Behavioral Risk Factor Surveillance System data is used for this study. The population examined is veterans' aged 50-75 with valid responses for CRCS and educational attainment (n=32,536). Bivariate analyses and survey adjusted and population weighted-multivariable logistic regression analyses are conducted to analyze the association between CRCS and education while adjusting for sex, race/ethnicity, income, health insurance coverage, having a primary care provider, employment status, and medical cost impeding care. Results: An estimated 6.5% of participants have less than a high school (HS) education, 30.5% are HS graduates, 37.0% have some college and 26.1% have a college degree or more. Seventy-three percent of individuals with less than HS, 77% of HS graduates, 84% of those with some college and 87% of those with a college degree or more have obtained CRCS. Given the adjusted model, education level and income level show a statistically significant trend (p Conclusion: CRCS is significantly linked to education and income. Given this trend, prevention programs should target veterans with low income and education to improve CRCS.