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Prevalence and predictors of colorectal cancer screening in the United States: evidence from the HINTS database 2018 to 2020

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Abstract

Background

The incidence of colorectal cancer (CRC) and CRC-related mortality among young adults (< 50 years) has been on the rise. The American Cancer Society (ACS) reduced the CRC screening age to 45 in 2018. Few studies have examined the barriers to CRC screening among young adults.

Methods

Analyses were conducted using data from 7,505 adults aged 45–75 years who completed the 2018 to 2020 Health Information National Trends Survey. We examined the sociodemographic characteristics associated with CRC screening overall and by age group using separate multivariable logistic regression models.

Results

76% of eligible adults had received screening for CRC. Increasing age, Black racial group [OR 1.45; 95% CI (1.07, 1.97)], having some college experience, a college degree or higher [OR 1.69; 95% CI (1.24, 2.29)], health insurance coverage [OR 4.48; 95% CI (2.96, 6.76)], primary care provider access [OR 2.48; 95% CI (1.91, 3.22)] and presence of a comorbid illness [OR 1.39; 95% CI (1.12, 1.73)] were independent predictors of CRC screening. Current smokers were less likely to undergo CRC screening [OR 0.59; 95% CI (0.40, 0.87)]. Among adults aged 50–64 years, being of Hispanic origin [OR 0.60; 95% CI (0.39, 0.92)] was associated with a lower likelihood of CRC screening.

Conclusion

CRC screening rates among adults 45–49 years are low but are increasing steadily. Odds of CRC screening among Blacks is high which is encouraging while the odds among current smokers is low and concerning given their increased risk of developing CRC.

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Data availability

The datasets analyzed during this study is publicly available from the Health Information and National Trends Survey (HINTS) website https://hints.cancer.gov/data/download-data.aspx

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Medicine, MedStar Health, Baltimore, MD, USA

    Joseph Atarere, Christopher Haas, Ted Akhiwu, Thilini Delungahawatta & Ashik Pokharel

  2. Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Joseph Atarere

  3. Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, USA

    Comfort Adewunmi

  4. Department of Medicine, University of Illinois College of Medicine, Peoria, IL, USA

    Eugene Annor

  5. Department of Anesthesiology, University of Pittsburgh Medical Centre, Williamsport, PA, USA

    Vwaire Orhurhu

  6. Department of Gastroenterology, MedStar Health, Baltimore, MD, USA

    Jasmine Barrow

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Contributions

JA: conception, methodology, formal analysis, writing—original draft preparation, writing—reviewing and editing. CH: supervision, writing—reviewing and editing, resources. TA: software, writing—reviewing and editing. TD: writing—original draft preparation. AP: writing—original draft preparation. CA: writing—original draft preparation. VO: resources, supervision, writing—reviewing and editing. JB: supervision, writing—reviewing and editing.

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Correspondence to Joseph Atarere.

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The data are de-identified and classified as exempt from review by the US National Institutes of Health, Office of Human Subjects Research Protections.

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All study participants provided written informed consent.

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Atarere, J., Haas, C., Akhiwu, T. et al. Prevalence and predictors of colorectal cancer screening in the United States: evidence from the HINTS database 2018 to 2020. Cancer Causes Control 35, 335–345 (2024). https://doi.org/10.1007/s10552-023-01795-8

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  • DOI: https://doi.org/10.1007/s10552-023-01795-8

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