Use Of Cancer Screening Research Articles

Adherence to colorectal cancer screening and healthcare resource utilization: a longitudinal analysis in Medicare beneficiaries aged 66–75 years

Objective In this study, we examined colorectal cancer (CRC) screening adherence in Medicare beneficiaries and associated healthcare resource utilization (HCRU) and Medicare costs. Methods Using 20% Medicare random sample data, the study population included Medicare fee-for-service beneficiaries aged 66–75 years on 1 January 2009, at average risk for CRC and continuously enrolled in Medicare Part A/B from 2008 to 2018. We excluded those who had undergone colonoscopy or flexible sigmoidoscopy during 2007–2008 and assumed everyone was due for screening in 2009; screening patterns were determined for 2009–2018. Based on US Preventive Services Task Force recommendations, individuals were categorized as adherent to screening, inadequately screened or not screened. HCRU and Medicare costs were calculated as mean per patient per year (PPPY). Results Of 895,846 eligible individuals, 13.2% were adherent to screening, 53.4% were inadequately screened, and 33.4% were not screened. Compared with those not screened, adherent or inadequately screened individuals were more likely to be female, White and have comorbidities. These individuals also used more healthcare services, generating higher Medicare costs. For example, physician visits were 14.6, 22.9 and 25.9 PPPY and total Medicare costs were $6102, $8469 and $9102 PPPY for those not screened, inadequately screened and adherent, respectively. Conclusions In Medicare beneficiaries at average risk, adherence to CRC screening was low, although the rate might be underestimated due to lack of early Medicare data. The link between HCRU and screening status suggests that screening initiatives independent of clinical visits may be needed to reach unscreened or inadequately screened individuals.

Utilisation of cervical cancer screening and factors associated with screening utilisation among women aged 30–49 years in Mertule Mariam Town, East Gojjam Zone, Ethiopia, in 2021: a cross-sectional survey

ObjectiveTo assess the practice of cervical cancer screening and its associated factors among women aged 30–49 years.DesignCommunity-based cross-sectional survey.SettingMertule Mariam Town, Northwest Ethiopia, 1 May–20 June 2021.ParticipantsWomen aged 30–49 years...

Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors.

PurposeTo examine whether sociodemographic characteristics, access to care, risk behavior factors, and chronic health conditions were associated with colorectal cancer (CRC) screening utilization among breast, cervical, prostate, skin, and lung cancer survivors.MethodsWe analyzed the 2020 Behavioral Risk Factor Surveillance System (BRFSS) data on 9780 eligible cancer survivors. Descriptive statistics and multivariable logistic regression models were applied to assess the association between guideline-concordant CRC screening and the mentioned characteristics.ResultsOverall, 81.9%, 65%, 88%,78.1%, and 80.1% of breast, cervical, prostate, skin, and lung cancer survivors received CRC screening, respectively (p-value < 0.001). In multivariable analysis, breast, cervical, and skin cancer survivors aged 60 years or older were associated with higher odds of receiving CRC screening. Respondents that had their recency of routine checkup two or more years before had lower odds of having CRC screening among cervical (OR = 0.06; 95% CI, 0.02–0.22), prostate (OR = 0.26; 95% CI, 0.14–0.49), and skin cancer (OR = 0.50; 95% CI, 0.36–0.70) survivors. The presence of chronic diseases was also associated with guideline-concordant CRC screening among breast, prostate, and skin cancer survivors.ConclusionsOur findings provide important evidence on potential factors that are associated with guideline-concordant CRC screening utilization across different cancer survivors, which include older age, recency of routine checkup, and multiple chronic diseases. Moreover, variation in CRC screening utilization across cancer survivors may highlight missed opportunities for secondary cancer prevention.Implications for Cancer SurvivorsEstablishing clear CRC screening guidelines and including patient-provider communication on recommendation in cancer survivorship care may increase adherence to CRC screening.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11764-022-01258-0.

Utilization of Cervical Cancer Screening and Associated Factors among Women in Bhaktapur, Nepal

Background Cervical cancer is the most common cancer among women in Nepal causing highest cancer mortality among women of reproductive age. However, it can be prevented through early and regular screening.&#x0D; Objective To assess utilization of cervical cancer screening, its awareness and perception among women, and associated factors.&#x0D; Method A cross-sectional study was conducted where 360 women of age 30-60 years were randomly selected and interviewed from five administrative wards of Bhaktapur municipality.&#x0D; Result Utilization of cervical cancer screening through Pap test or Visual Inspection with Acetic acid was found in 32.2% women and 47.8% were aware of cervical cancer and its screening tests. 100% of them had high level of perceived benefits and facilitators. More than 80% of them had low level of perceived barriers and susceptibility. Women of age group 51-60 years were more likely to perform the screening test (AOR=13.14) whereas unemployed women were at higher odds of performing the test (AOR=3.29). Women who were aware of cervical cancer and its screening were more likely to perform the screening (AOR=53.65). Women having low level of perceived barriers (AOR=5.83) and high level of perceived seriousness (AOR=6.67) were more likely to perform the screening.&#x0D; Conclusion Only one third of women had performed Pap test/VIA and those who were aware of cervical cancer and had high level of perception were more likely to perform the screening. Thus, more rigorous and tailor-made awareness programs should be developed by health program planners to increase the screening rate among younger and working women.

Fatalistic cancer beliefs and self-reported cancer screening behaviors among diverse urban residents.

Cancer fatalism-the belief that death is inevitable when cancer is present-has been identified as a barrier to cancer screening, detection, and treatment. Our study examined the relationship between self-reported cancer fatalism and adherence to cancer screening guidelines of the breasts, cervix, colon, and prostate among a diverse sample of urban-dwelling adults in Brooklyn, New York. Between May 2019 and August 2020, we conducted a cross-sectional survey of adults 40 + years of age (n = 2,341) residing in Brooklyn neighborhoods with high cancer mortality. Multivariable logistic regression models were used to assess the odds of reporting cancer screening completion across three fatalistic cancer belief categories (low, med, high). Participants' median age was 61 (IQR 51, 71) years, 61% were women, 49% self-identified as non-Hispanic black, 11% Hispanic, 4% Asian, and 6% more than one race. There were no statistically significant differences in the proportion of low, some, or high fatalistic beliefs identified among male respondents compared to women. Among women, we observed that high fatalistic cancer beliefs were associated with higher odds (OR 2.01; 95% CI 1.10-3.65) of completing breast but not cervical (1.04; CI 0.55-1.99) or colon (1.54; CI 0.88-2.69) cancer screening. Men with high fatalistic cancer beliefs had a trend towards lower odds of prostate screening (OR 0.53: 95% CI 0.18-1.57) compared to men with low fatalistic beliefs, but neither was statistically significant. Findings suggest that high fatalistic cancer beliefs may be an important factor in cancer screening utilization among women. Further examination in longitudinal cohorts with a larger sample of men may be needed in order to identify any significant effect.

Impact of Alzheimer's disease and related dementias on colorectal cancer screening utilization, knowledge, and associated health disparities.

Background: Colorectal cancer screening can detect colorectal cancer at an early stage and reduce mortality. None of the existing clinical practice guidelines provide specific recommendations for colorectal cancer screening in patients with Alzheimer’s disease and related dementias (ADRD). Limited studies have assessed the impacts of ADRD on colorectal cancer screening use and knowledge, and no studies have focused on the associated health disparities. Objectives: To examine the utilization, knowledge, and associated health disparities of colorectal cancer screening in older adults with ADRD. Methods: This study used the Medicare Current Beneficiary Survey from 2015 to 2018. Two types of colorectal cancer screening, including fecal occult blood test (FOBT) and colonoscopy/sigmoidoscopy, were measured. The colorectal cancer screening knowledge was evaluated by asking if the participants have heard of two screening methods and whether they knew Medicare pays for colorectal cancer screenings. Logistic regression models were used to examine the impact of ADRD diagnosis on the utilization and knowledge of colorectal cancer screening. Results: The overall colorectal cancer screening rate in older adults increased from 86.4% to 88.96% from 2015 to 2018. Patients with AD were 39% (OR: 0.61; 95% CI: 0.50–0.76) less likely and those with RD were 25% (OR: 0.75; 95% CI: 0.62–0.91) less likely to use any colorectal cancer screening when compared to older adults without ADRD. The rate of knowledge of colonoscopy/sigmoidoscopy remained high between 84.23% and 84.57% while the knowledge of FOBT increased from 64.32% to 78.69% during the study period. Compared to older adults without ADRD, those with AD were 77% (OR: 1.77; 95% CI: 1.12–2.81) more likely to hear of colonoscopy/sigmoidoscopy. The rate of knowledge of Medicare pay for colorectal cancer screening increased from 42.19% to 45.27% during the study period. Compared to older adults without ADRD, those with AD were 19% (OR: 0.81; 95% CI: 0.70–0.94) less likely to know that Medicare pays for colorectal cancer screening. Conclusion: ADRD was significantly associated with colorectal cancer screening utilization and knowledge. In addition, this study identified health disparities in race/ethnicity, gender, and urban/rural residence in colorectal cancer screening use and knowledge.

32381 Analysis of utilization of skin cancer screenings and screening motivations among national SPOT Skin Cancer program screenees from 2018 to 2019

Information on motivations for participation in the AAD SPOT Skin Cancer screenings is lacking, and understanding differences in motivations may help elucidate potential disparities in free skin cancer screening in the United States, informing the program where resources may be most needed. Records from 116,595 screenees were analyzed from 2018-2019, including demographic information, history of regular dermatologist and/or screening, and motivation(s) for screening attendance. Most screenees were White (86.3%), female (61.8%), and had completed at least a college education (69.6%). Higher ZIP code level income per $10,000 increments was associated with a higher likelihood of having a regular dermatologist or having been to a prior screening (adjusted odds ratio [aOR] = 1.04, P < .001 and aOR = 1.05, P < .001, respectively). “No regular dermatologist” or “not having been to a prior screening” were screening motivations more commonly reported by non-Whites versus Whites, those with less education versus graduate-level education, and those living in the Midwest versus Northeast. Having a concerning spot and no dermatologist were the most common motivations for attending a screening (36.3% and 26.2%, respectively). Screenees who had attended a prior screening were less likely than those who had not to report a spot of concern (aOR = 0.75, P < .001). The program appears effective in addressing its intended target of screenees with a concerning spot but had not obtained expert skin examination. A major limitation is screenee self-selection. Nonetheless, our data suggest the screenings could possibly be optimized by targeting individuals without a dermatologist, are uninsured/underinsured, reside in lower-income areas, and/or in the Midwest.

Predictors of Nonadherence to Colorectal Cancer Screening among Hospitalized Women.

Despite proven mortality benefit, disparities in colorectal cancer (CRC) screening utilization persist, especially among younger women, minorities, and low-income women, even those who are insured. The purpose of the present study is to evaluate and estimate the effects of sociodemographic and clinical variables associated with nonadherence to CRC screening among hospitalized women. A cross-sectional bedside survey was conducted to collect sociodemographic and clinical comorbidity data believed to affect CRC screening adherence of hospitalized women aged 50 to 75 years who were cancer free (except skin cancer) at enrollment. Logistic regression models were used to assess the association between these factors and nonadherence CRC screening. In total, 510 women were enrolled for participation in the study. After adjustment for sociodemographic and clinical predictors, only two variables were found to be independently associated with nonadherence to CRC screening: age younger than 60 years (odds ratio [OR] 2.62, 95% confidence interval [CI] 1.58-4.33) and nonadherence to breast cancer screening (OR 3.72, 95% CI 2.29-6.04). By contrast, hospitalized women at high risk for CRC were more likely to be compliant with CRC screening (OR 0.14, 95% CI 0.04-0.50). Both younger age and behavior toward screening remain barriers to CRC screening. Hospitalization creates an environment where patients are in close proximity to healthcare resources, and strategies could be used to capitalize on this opportunity to counsel, educate, and motivate patients toward this screening that is necessary for health maintenance. Seizing on this opportunity may help improve CRC screening adherence.

Rural Cancer and the Opioid Epidemic: Are Screening Disparities Further Exacerbated?

Objective: Rural areas experience significant disparities in cancer incidence and mortality and are also disproportionately impacted by the drug use epidemic. People who use drugs (PWUDs) frequently experience healthcare-associated stigma sufficient to cause avoidance of all non-urgent care. Research associated with cancer risk and screening utilization among rural PWUDs is nearly nonexistent. Methods: We searched PubMed for articles describing rural healthcare access and cancer disparities, and drug use and healthcare-associated stigma. Results: Rural populations frequently experience increased rates of circumstances and behaviors associated with increased cancer risk, morbidity, and mortality, but also lesser access to and use of healthcare. Rural areas have been disproportionately impacted by many types of drug use, and the stigma PWUDs frequently encounter leads to deferred care and poorer health outcomes. The limited data suggest that PWUDs experience at least equal cancer risk as their non-PWUD peers but obtain screening less often. Whereas interventions to increase medical care engagement among PWUDs have succeeded, none has explored cancer risk and screening. Conclusions: Although there are mechanisms to increase cancer screening in rural areas, and methods to increase healthcare engagement for PWUDs, research should combine these evidence-based practices to explore implementation in this population with distinct risk profiles.

Are Wellness Visits a Possible and Effective Cure for the Increasing Cancer Burden in Poland? Example of Women's Preventive Services in the U.S.

Simple SummaryCancer remains one of the leading causes of death in Poland as well as in the United States. Modifiable risk factors, such as tobacco use, obesity, and low utilization of preventive cancer screenings, all contribute to greater cancer incidence and mortality in both countries. However, these risk factors have triggered some mitigating solutions in the U.S not seen in Poland, namely the implementation of standard annual wellness visits fully covered by health insurance. The aim of this study was to determine the level of impact that standardized, preventive wellness visits have had on uptake of cancer prevention measures, namely cancer screenings, among women in a largely rural region of the U.S. where cancer risk is often high. Based on the observation that wellness visits are associated with greater use of cancer screenings and other preventive health behaviors, findings from this study were used to support the inclusion of no-cost wellness visits into proposed strategies for systemic solutions to reduce cancer burden in Poland.Background: Cancer is one of the leading causes of death among Polish women in general, and first in women aged 25–64. Contributing to this cancer burden are modifiable behavioral risk factors, including low utilization of cancer screenings. Poland has an urgent need for new systemic solutions that will decrease cancer burden in the female Polish population. This study examined the United States’ implementation of preventive wellness visits as a viable solution for implementation in Poland. Methods: Health insurance claims data for nearly three million women in five states of the U.S. were examined to identify use of mammograms, colorectal cancer screening, and lung cancer screening. Three subgroups of the cohort were assessed for the probability of receipt of screening associated with type of healthcare visit history (women with wellness visits—W; with wellness visits and related preventive services and screenings—W+P; and control group—C). All multiple comparisons were significant (alpha = 0.05) at p < 0.0001, except comparison between subgroups (W vs. P+W) for lung cancer screening. Results: Breast and colorectal cancer screenings had substantially higher participation after W and W+P in comparison with C; moreover, a slight increase after W or P+W was seen for lung cancer as well. Conclusions: Results indicate that wellness visits are an effective tool for increasing cancer screening among women in the U.S. Introduction of a similar solution in Poland could potentially help produce higher screening rates, address cancer prevention needs (not only for secondary cancer prevention), and lower cancer burden.

Determinants of cervical cancer screening utilization among women in Southern Ethiopia

Cervical cancer has been an important public health problem. Despite the availability of screening services, its utilization in Ethiopia is low. This study therefore, aimed to identify contextual predictors of cervical cancer screening utilization among eligible women. This study employed facility-based unmatched case–control study design. Data were collected from 410 participants using interviewer-administered techniques. The collected data were entered using EpiInfo version 7 and transported to SPSS version 20 for statistical analysis. We performed descriptive analysis and logistic regression to identify predictors of screening utilization. This study demonstrated that urban residence, being in marital union, membership in women development army, knowledge of cervical cancer screening location, use of maternal health care in the previous year and knowledge on cervical cancer and its screening were predictors of screening utilization. Therefore, it is important to improve women’s knowledge on cervical cancer, promote maternal health care use, disseminate health information through women’s groups and consider all positive effects of urban residence among rural women to improve screening utilization.

EP01.03-007 Lung Cancer Screening Use Among Screening-Eligible Adults With Disability in the United States: Evidence From Population-Based Data

Lung cancer continues to be the leading cause of cancer-related death in the United States (US). Annual screening with low-dose computed tomography is shown to detect lung cancer earlier and significantly decrease mortality. Yet, lung cancer screening use among adults with disability is understudied. This study estimated the prevalence of disability and investigated the association between disability status and lung cancer screening utilization among adults at increased risk for lung cancer in the US.

Ovarian cancer risk-reduction and screening in BRCA 1/2 mutation carriers (383)

<b>Objectives:</b> To determine the utilization of risk-reducing strategies and screening protocols for ovarian cancer in female <i>BRCA1/2</i> carriers. <b>Methods:</b> A multi-center, cross-sectional survey was conducted among <i>BRCA1/2</i> mutation carriers unaffected by cancer. The questionnaire was administered electronically via email using REDCap with two reminder emails. There were 2-23 fixed-response questions, including questions on genetic testing and risk-reducing decisions. Data were analyzed with Fisher's exact test. <b>Results:</b> The survey was completed by 105 female <i>BRCA</i> mutation carriers (34% response rate). <i>BRCA</i> subtypes included 54.3% <i>BRCA 2,</i> 41.0% <i>BRCA 1</i> and 2.9% of both. The age at which patients underwent genetic testing varied, with 21.0% within the age range of 18-24 years (yr), 24.8% within 25-34 yr, 30.5% 35-44 yr, 17.1% were 45-54 yr and 6.7% were >55 years. The majority of ordering providers were genetic counselors (57.1%), with fewer tests ordered by OBGYNs (18.1%), primary care providers (4.8%), gynecologic oncologists (4.8%), and breast surgeons (3.8%). Approximately half (55.8%) of respondents reported having been offered increased screening for possible early detection of ovarian cancer. Of the 79 women who performed their genetic testing before 45 years, 41.8% underwent increased ovarian cancer screening with either transvaginal ultrasound alone (21.2%), CA-125 alone (12.1%), or combined (63.6%). There were no differences seen in screening utilization based on <i>BRCA</i> mutation type <i>(BRCA1</i> 40.0% vs <i>BRCA2</i> 42.5%; p=0.93). Nearly all respondents (97.1%) reported that a provider had discussed risk-reducing surgeries. Sixty women underwent a risk-reducing bilateral salpingo-oophorectomy, which was recommended in similar proportions by gynecologic oncologists (58.3%), OBGYNs (48.3%), and genetic counselors (46.7%). Overall, 43.3% of respondents reported that a healthcare provider recommended taking combined oral contraceptive pills to reduce their risk of ovarian cancer, and of these women, 86.7% chose to use them. Combined oral contraceptive pills were offered at higher rates among women who were younger at age of genetic testing (18-24 yr: 86%, 25-34 yr: 62%, 35-44 yr: 23%; p<0.0001) as well as women with <i>BRCA1</i> mutations <i>(BRCA1:</i> 60%, <i>BRCA2:</i> 43%; p=0.048). <b>Conclusions:</b> In our cohort of female <i>BRCA</i> mutation carriers, ovarian cancer screening was offered to only half of the women. While the majority had discussed surgical options, less than half of women received recommendations to use medication-based risk-reduction. Further investigation is needed to identify barriers to utilization of ovarian cancer screening and nonsurgical risk-reduction among this high-risk population.

Determinants of utilization of cervical cancer screening among women in the age group of 30-49 years in Ambo Town, Central Ethiopia: A case-control study.

Globally, cervical cancer is the second most common and the leading cause of death in women in low-income countries. It is one of the potentially preventable cancers, and an effective screening program can result in a significant reduction in the morbidity and mortality associated with this cancer; however, evidence showed that only a small percentage of the women were screened. As a result, predictors of cervical cancer screening usage among women in Ambo town, central Ethiopia, were identified in this study. Unmatched, a community-based case-control study was conducted among 195 randomly sampled women in the age group of 30-49 years in Ambo town from February 1 to March 30, 2020. Data was collected using an interviewer-administered questionnaire. Descriptive, bivariate, and multivariable binary logistic regression analysis was done using SPSS. A total of 195 study participants, sixty-five cases and one hundred thirty controls, participated in this study, making a response rate of 100%. Being in the age group of 30-34 years old (AOR = 0.2; 95% CI: 0.06-0.7), being Para five and above (AOR = 4.5; 95% CI: 1.4-14.1), modern contraceptive utilization (AOR = 5.4; 95% CI: 1.8-16.3) and having high-level knowledge regarding cervical cancer screening and its predisposing factors (AOR = 5.9; 95% CI: 2-17) were significantly associated with the utilization of cervical cancer screening. The age of women, parity, use of modern contraception, and level of knowledge regarding cervical cancer screening and its predisposing factors were the determinants of the utilization of cervical cancer screening among women. As a result, the media, the health bureau, and health professionals should advocate raising awareness about cervical cancer and its preventative methods, which are primarily focused on screening.

Stage-Specific Risk of Breast Cancer among Canadian Immigrant and Non-Immigrant Women.

Breast cancer screening utilization varies across immigrant and non-immigrant populations. Recent studies have also suggested that some immigrant populations in Canada present with a higher frequency of later-stage breast cancer compared to non-immigrants. Our study aimed to augment prior research by presenting breast cancer stage distributions and stage-specific breast cancer incidence rates for immigrant and non-immigrants in British Columbia, Canada. We utilized a population-based cohort of more than 1.3million women built from linked administrative health and immigration data sets. Age-standardized incidence rate ratios were generated to compare immigrant and non-immigrant groups. Poisson regression was used to assess the relative frequency of later stage diagnosis among immigrant groups compared to non-immigrants. Indian and Chinese immigrants both showed significantly lower stage I and stage II-IV incidence rates compared to non-immigrants. However, Indian immigrants showed a higher frequency of later stage tumours at diagnosis compared to non-immigrants, while in contrast Chinese immigrants showed a lower frequency of later stage tumours. Filipino immigrants showed similar stage-specific rates and stage at diagnosis compared to non-immigrants. Our findings highlight a need for continued surveillance of cancer among immigrant and non-immigrant populations and inquiry into reasons for differences in stage at diagnosis across groups.

Lower Compliance with Cervical Cancer Screening Guidelines Among Vegetarians in North America.

Cervical cancer is preventable and treatable through regular screening and follow-up. However, the utilization of cervical cancer screening may vary widely based on individual lifestyles. The purpose of this study was to examine the differences in the adherence to cervical cancer screening guidelines in various dietary groups. Our study included 21,376 women from the United States and Canada, aged 30-69 from the Adventist Health Study-2, a large population-based prospective cohort study. Modified Poisson regression with robust variance estimation was used to determine the prevalence ratios of cervical cancer screening behavior in participants following five different dietary patterns (non-vegetarians, semi-vegetarians, pesco-vegetarians, lacto-ovo-vegetarians, and vegans). All analyses were adjusted for age, race/ethnicity, marital status, education, personal income, body mass index, smoking, alcohol use, exercise, and family history of all female cancer. Vegetarians, in general, had similar screening prevalence as non-vegetarians. However, vegans were 16% less likely to have had a Pap test compared to non-vegetarians (prevalence ratio (PR) = 0.84, 95% confidence interval 0.81-0.86). Women who were younger, Black, married, more educated, had a family history of all female cancer, had a higher income, and exercise reported higher compliance to a Pap test. It remains to be seen whether vegan women in Adventist Health-2 experience a higher incidence of cervical cancer or are diagnosed at a later stage compared to non-vegetarians.

Participation in Colorectal Cancer Screening among Migrants and Non-Migrants in Germany: Results of a Population Survey

Colorectal cancer screening can contribute to reducing colorectal cancer incidence and mortality. Findings on disparities in the utilization of colorectal cancer screening between migrants and non-migrants have been inconsistent, with some studies reporting lower, and some higher utilization among migrants. The aim of the present study was to examine potential disparities in fecal occult blood testing and colonoscopy among migrants in Germany. Data from a population survey on 11,757 men and women aged ≥50 years is used. Using multivariable logistic regression, the utilization of fecal occult blood testing and colonoscopy was compared between non-migrants, migrants from EU countries and migrants from non-EU countries, adjusting for socio-economic factors and also taking into account intersectional differences by sex and age. The study shows that migrants from the EU (adjusted OR = 0.73; 95%-CI: 0.57, 0.94) and from non-EU countries (adjusted OR = 0.39; 95%-CI: 0.31, 0.50) were less likely to utilize fecal occult blood testing than non-migrants. No disparities for the use of colonoscopy were observed. The findings are in line with studies from other countries and can be indicative of different barriers migrants encounter in the health system. Adequate strategies taking into account the diversity of migrants are needed to support informed decision-making among this population group.

Colorectal cancer screening in sub-Saharan Africa

Colorectal cancer screening in sub-Saharan Africa

Patterns of Colorectal Cancer in Texas Counties From 2000 to 2017.

Residents living in Texas counties along the United States-Mexico border make up a unique demographic. These counties consist of a large proportion of Hispanic-Latinx people who experience a high rate of health uninsurance and underinsurance, low household income averages, and, as a whole, exhibiting relatively poor health outcomes compared to the US general population. Limited information exists regarding the effects of these characteristics on the incidence of colorectal cancer (CRC). Using data from the Texas Department of State Health Service, we calculated that the overall age-adjusted incidence rate (AAIR) of CRC was lower and decreased at a slower rate over time in Texas border counties compared with nonborder counties in Texas. The AAIR of CRC was lower and decreased at a slower rate over time in Texas border counties compared with nonborder counties in Texas. Conversely to other groups analyzed, the AAIR of CRC in individuals age 50-64 years in border counties increased. These findings are likely a reflection of less utilization of cancer screening in border counties than in nonborder counties. The increase in AAIR of CRC among individuals age 50-64 years in border counties warrants further investigation.

Association Between Body Mass Index and Cancer Screening Adherence Among Latinas in the United States and Puerto Rico.

Research on the role of body size on cancer screening is mixed with few studies among Latinas in the United States. We evaluated the association between body size and cancer screening adherence among Latinas living in Puerto Rico and the rest of the United States. We conducted a cross-sectional study using 2012-2018 Behavioral Risk Factor Surveillance System data among Latinas 50-64 years of age (n = 16,410). Breast, cervical, and colorectal cancer screening (guideline adherent: yes/no), height and weight were self-reported. Prevalence ratios (PRs) derived from Poisson models were estimated for each cancer screening utilization for Puerto Rico versus rest of the United States by body mass index (BMI) category. Nearly a quarter of women lacked adherence with breast and cervical cancer screening and 43.6% were nonadherent to colorectal cancer screening. Latinas with BMI ≥40.0 kg/m2 in both groups were more likely to lack adherence to cervical cancer screening than women with BMI 18.5-24.9 kg/m2. For those with BMI ≥40.0 kg/m2, Latinas in Puerto Rico were more likely to lack adherence to colorectal cancer screening recommendations than Latinas living in the rest of the United States (adjusted PR: 1.38; 95% confidence interval = 1.12-1.70). The role of body size in cancer screening utilization among Latinas differs in women living in Puerto Rico versus in the rest of the United States and varies by cancer type. Understanding Latinas' experience can inform culturally adapted interventions to promote cancer screening.