ABSTRACT
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.
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Acknowledgments
This work was done while the primary author was an ASPH/CDC Public Health Fellow supported by Cooperative Agreement Number U36/CCU300430 from the CDC to the Association of Schools of Public Health. The NHIS and the preparation of the manuscript were entirely funded by the US government. The authors would like to acknowledge Zahava Berkowitz of the Division of Cancer Prevention and Control, CDC for statistical assistance and Charlotte Schoenborn of the NCHS, CDC for assistance with physical activity recodes. The authors would also like to acknowledge Henry Kahn and Gloria Beckles of the Division of Diabetes Translation, CDC for reviewing and commenting on an earlier version of this manuscript.
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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.
Implications
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.
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Adjaye-Gbewonyo, K., Sabatino, S.A. & White, M.C. Exploring opportunities for colorectal cancer screening and prevention in the context of diabetes self-management: an analysis of the 2010 National Health Interview Survey. Behav. Med. Pract. Policy Res. 3, 72–81 (2013). https://doi.org/10.1007/s13142-012-0187-7
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DOI: https://doi.org/10.1007/s13142-012-0187-7
KEYWORDS
- Colorectal cancer
- Cancer screening
- Diabetes mellitus
- Self-management
- Self-care
- Health behaviors
- Multiple health behavior change