TY - JOUR
T1 - Low colorectal cancer screening uptake and persistent disparities in an underserved urban population
AU - Ni, Katherine
AU - O'Connell, Kelli
AU - Anand, Sanya
AU - Yakoubovitch, Stephanie C.
AU - Kwon, Simona C.
AU - De Latour, Rabia Ali
AU - Wallach, Andrew B.
AU - Sherman, Scott E.
AU - Du, Mengmeng
AU - Liang, Peter S.
N1 - Publisher Copyright:
© 2020 American Association for Cancer Research.
PY - 2020
Y1 - 2020
N2 - Colorectal cancer screening has increased substantially in New York City in recent years. However, screening uptake measured by telephone surveys may not fully capture rates among underserved populations. We measured screening completion within 1 year of a primary care visit among previously unscreened patients in a large urban safety-net hospital and identified sociodemographic and health-related predictors of screening. We identified 21,256 patients ages 50 to 75 who were seen by primary care providers (PCP) in 2014, of whom 14,425 (67.9%) were not up-to-date with screening. Because PCPs facilitate the majority of screening, we compared patients who received screening within 1 year of an initial PCP visit to those who remained unscreened using multivariable logistic regression. Among patients not up-to-date with screening at study outset, 11.5% (1,658 patients) completed screening within 1 year of a PCP visit. Asian race, more PCP visits, and higher area-level income were associated with higher screening completion. Factors associated with remaining unscreened included morbid obesity, ever smoking, Elixhauser comorbidity index of 0, and having Medicaid/Medicare insurance. Age, sex, language, and travel time to the hospital were not associated with screening status. Overall, 39.9% of patients were up-to-date with screening by 2015. In an underserved urban population, colorectal cancer screening disparities remain, and overall screening uptakewas low. Because more PCP visits were associated with modestly higher screening completion at 1 year, additional communitylevel education and outreach may be crucial to increase colorectal cancer screening in underserved populations.
AB - Colorectal cancer screening has increased substantially in New York City in recent years. However, screening uptake measured by telephone surveys may not fully capture rates among underserved populations. We measured screening completion within 1 year of a primary care visit among previously unscreened patients in a large urban safety-net hospital and identified sociodemographic and health-related predictors of screening. We identified 21,256 patients ages 50 to 75 who were seen by primary care providers (PCP) in 2014, of whom 14,425 (67.9%) were not up-to-date with screening. Because PCPs facilitate the majority of screening, we compared patients who received screening within 1 year of an initial PCP visit to those who remained unscreened using multivariable logistic regression. Among patients not up-to-date with screening at study outset, 11.5% (1,658 patients) completed screening within 1 year of a PCP visit. Asian race, more PCP visits, and higher area-level income were associated with higher screening completion. Factors associated with remaining unscreened included morbid obesity, ever smoking, Elixhauser comorbidity index of 0, and having Medicaid/Medicare insurance. Age, sex, language, and travel time to the hospital were not associated with screening status. Overall, 39.9% of patients were up-to-date with screening by 2015. In an underserved urban population, colorectal cancer screening disparities remain, and overall screening uptakewas low. Because more PCP visits were associated with modestly higher screening completion at 1 year, additional communitylevel education and outreach may be crucial to increase colorectal cancer screening in underserved populations.
UR - http://www.scopus.com/inward/record.url?scp=85082778338&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082778338&partnerID=8YFLogxK
U2 - 10.1158/1940-6207.CAPR-19-0440
DO - 10.1158/1940-6207.CAPR-19-0440
M3 - Article
C2 - 32015094
AN - SCOPUS:85082778338
SN - 1940-6207
VL - 13
SP - 395
EP - 402
JO - Cancer Prevention Research
JF - Cancer Prevention Research
IS - 4
ER -