Increased comorbidities linked to decreased colorectal cancer screening
Patients with five or more comorbidities were less likely to receive screening for colorectal cancer, according to research published in the Journal of Osteopathic Medicine.
“Screening has been identied as an efcient way to reduce CRC morbidity and mortality, with a large U.S. study noting that an increase in screening adherence of roughly 40% corresponded with a 52% reduction in cancer mortality,” Benjamin Greiner, DO, MPH, department of internal medicine at The University of Texas Medical Branch, and colleagues wrote. “Therefore, further research is warranted to understand characteristics that contribute to the likelihood of a patient not being screened.”
In a cross-sectional analysis, researchers used the 2018 and 2019 Behavioral Risk Factor Surveillance System self-reported health survey to analyze CRC screening rates in patients with comorbidities vs. patients without comorbidities. They further determined adjusted risk ratios (aRRs) as they correlated with the number of comorbidity diagnoses.
Of 279,784 respondents, 79.7% reported receiving screening for CRC at guideline recommended intervals. Researchers noted patients with diabetes, hypertension, skin cancer, chronic obstructive pulmonary disease, arthritis, depression and chronic kidney disease were more likely to receive screening for CRC compared with patients with no comorbidities. Further, patients with one comorbidity (aRR = 1.11; 95% CI, 1.09–1.12), two to four comorbidities (aRR = 1.2; 95% CI, 1.18–1.22) and five or more comorbidities (ARR = 1.12; 95% CI, 1.1–1.14) were more likely to be screened for CRC than those with zero comorbidities. However, respondents reporting ve or more comorbidities were less likely to receive screening compared with those with two to four comorbidities (aRR = 1.12; 95% CI, 1.1– 1.14 vs. aRR = 1.2; 95% CI, 1.18–1.22).
“Patients with all types of comorbidities were significantly more likely to have been screened for CRC. ... Interestingly, a negative effect was seen amongst individuals with five or more reported comorbid conditions; we saw screening rates decline as medical history became more extensive, possibly due to physician burnout and patient complexity,” Greiner and colleagues concluded. “Any type of CRC screening is beneficial for reducing cancer morbidity and mortality and screening should be strongly considered. ... Further efforts are warranted to discover disparities in CRC screening usage.”