Date: 18 Jan 2013
Exploring opportunities for colorectal cancer screening and prevention in the context of diabetes self-management: an analysis of the 2010 National Health Interview Survey
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Because diabetes is associated with increased colorectal cancer (CRC) risk, it is important that people with diabetes receive CRC screenings according to guidelines. In addition, many diabetes self-care recommendations are associated with a reduced risk of CRC. This study aims to identify potential opportunities for enhancing CRC prevention within the context of diabetes management. Using data from 1,730 adults with diabetes aged 50–75 years who responded to the 2010 National Health Interview Survey, we calculated population estimates of behaviors consistent with US Preventive Services Task Force guidelines for CRC screening and American Diabetes Association recommendations for diabetes care. We examined bivariate associations between CRC screening and selected diabetes self-care behaviors associated with CRC risk. Results were stratified by demographic characteristics. Thirty-nine percent of adults with diagnosed diabetes were not up-to-date with CRC screenings. Sixteen percent smoked and 2 % exceeded alcohol intake recommendations. Among those capable of exercise, 69 and 90 % did not meet aerobic exercise and resistance training recommendations, respectively. CRC screening was generally not associated with diabetes self-care behaviors. Among some demographic groups, CRC screening was associated with adequate aerobic activity, not smoking, and being overweight or obese. Many adults with diabetes do not follow guidelines for CRC screening or recommendations for diabetes care that may also reduce CRC risk. Thus, opportunities may exist to jointly promote CRC screening and prevention and diabetes self-management among adults with diabetes.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Association of Schools of Public Health.
Practice: Adults with diabetes in the 50- to 75-year age group who are not meeting recommended behaviors for diabetes self-management should be screened for failure to meet other recommended diabetes self-care behaviors and counseled about colorectal cancer screening.
Policy: Resources should be directed toward encouraging the coordination of programs aimed at the prevention and management of chronic conditions with shared risk factors or co-morbidity.
Research: Future research efforts should aim to identify effective interventions that optimize the use of recommended CRC screening and promote good patient outcomes in adults with diabetes.
U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2008 Incidence and Mortality Web-based Report. Available from www.cdc.gov/uscs.
Centers for Disease Control and Prevention. National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention; 2011.
Centers for Disease Control and Prevention. Surveillance of demographic characteristics and health behaviors among adult cancer survivors—behavioral risk factor surveillance system, United States, 2009. MMWR. 2012;61:1-23.
Richardson LC, Pollack LA. Therapy insight: influence of type 2 diabetes on the development, treatment and outcomes of cancer. Nat Rev Clin Oncol. 2005;2:48-53.CrossRef
U.S. Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:627-637.
American Diabetes Association. Standards of medical care in diabetes—2009. Diabetes Care. 2009;32(Suppl 1):S13-S61.CrossRef
Joshu CE, Parmigiani G, Colditz GA, Platz EA. Opportunities for the primary prevention of colorectal cancer in the United States. Cancer Prev Res (Phila). 2012;5:138-145.CrossRef
National Cancer Institute. Colorectal cancer prevention (PDQ®). Available from http://cancer.gov/cancertopics/pdq/prevention/colorectal/HealthProfessional/page2. Accessed 2 March 2012
Heinrich KM, Maddock J. Multiple health behaviors in an ethnically diverse sample of adults with risk factors for cardiovascular disease. Perm J. 2011;15:12-18.PubMed
Owens MD, Beckles GLA, Ho KK-Y, et al. Women with diagnosed diabetes across the life stages: underuse of recommended preventive care services. J Women’s Health. 2008;17:1415-1423.CrossRef
Wilkinson JE, Culpepper L. Associations between colorectal cancer screening and glycemic control in people with diabetes, Boston, Massachusetts, 2005–2010. Prev Chronic Dis. 2011;8:A82.PubMed
National Center for Health Statistics. 2010 National Health Interview Survey (NHIS) Public Use Data Release: NHIS Survey Description. Available from ftp://ftp.cdc.gov/pub/health_statistics/nchs/dataset_documentation/nhis/2010/srvydesc.pdf. Accessed 6 December 2011
Centers for Disease Control and Prevention. Cancer screening—United States, 2010. MMWR Morb Mortal Wkly Rep. 2012;61:41-45.
U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Atlanta, GA, 2008.
Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report. Washington, DC, 2008.
World Cancer Research Fund, American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington, DC, 2007.
National Center for Health Statistics. NHIS—Adult Physical Activity Information: Leisure-time Physical Activity Recodes. Available from http://www.cdc.gov/nchs/nhis/physical_activity/pa_recodes.htm. Accessed 17 November 2011
National Center for Health Statistics. Health, United States, 2010: With Special Feature on Death and Dying. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2010. 2011.
Research Triangle Institute. SUDAAN Language Manual, Release 10.0. Research Triangle Park: Research Triangle Institute; 2008.
Carter-Pokras OD, Johnson TM, Bethune LA, et al. Lost opportunities for smoking cessation among adults with diabetes in Florida (2007) and Maryland (2006). Prev Chronic Dis. 2011;8:A51.PubMed
Fagan HB, Wender R, Myers RE, Petrelli N. Obesity and cancer screening according to race and gender. J Obes. 2011;2011:218250.PubMed
Bantle JP, Wylie-Rosett J, Albright AL, et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2008;31(Suppl 1):S61-S78.PubMed
American Cancer Society (2011). Colorectal cancer. Available from http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf. Accessed 2 December 2011
Barnes PM, Schoenborn CA. Trends in adults receiving a recommendation for exercise or other physical activity from a physician or other health professional. NCHS Data Brief, no. 86. Hyattsville: National Center for Health Statistics; 2012.
National Institutes of Health. Meeting Summary. Bethesda: NIH Science of Behavior Change. 2009.
U.S. Department of Health and Human Services. Multiple chronic conditions—a strategic framework: optimum health and quality of life for individuals with multiple chronic conditions. Washington, DC, 2010.
Sabatino SA, Lawrence B, Elder R, et al. Community Preventive Services Task Force. Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: nine updated systematic reviews for The Guide to Community Preventive Services. Am J Prev Med. 2012;43(1):765-786.CrossRef
Centers for Disease Control and Prevention. Coordinated Chronic Disease Program Launched. Available from http://www.cdc.gov/Features/ChronicDiseaseProgram/. Accessed 28 March 2012
U.S. Department of Health and Human Services. Behavioral Interventions to Address Multiple Chronic Health Conditions in Primary Care (R01). Available from http://grants.nih.gov/grants/guide/pa-files/PA-12-024.html. Accessed 28 March 2012
- Exploring opportunities for colorectal cancer screening and prevention in the context of diabetes self-management: an analysis of the 2010 National Health Interview Survey
Translational Behavioral Medicine
Volume 3, Issue 1 , pp 72-81
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Colorectal cancer
- Cancer screening
- Diabetes mellitus
- Health behaviors
- Multiple health behavior change
- Author Affiliations
- 1. Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS K-55, Atlanta, GA, 30341, USA
- 2. Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building 7th floor, Boston, MA, 02115, USA