April 05, 2017
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Colorectal cancer screening lower in adults with disabilities

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Adults with certain disabilities are less likely to undergo recommended colorectal cancer screening compared with individuals without disabilities, according to the results of a 10-year study.

“Colorectal cancer is the second leading cause of cancer deaths in the U.S.,” Chelsea B. Deroche, PhD, assistant professor of biostatistics in the Missouri University Department of Health Management and Informatics and in the Biostatistics and Research Design Unit, said in a press release. “However, almost 60% of these deaths could be prevented if people ages 50 years or older received routine screenings. When studying adherence rates to recommended screenings, we found that individuals with blindness or low vision, an intellectual disability or a spinal cord injury are less likely to receive screenings than those without these disabilities.”

Chelsea B. Deroche, PhD

Chelsea B. Deroche

Deroche and colleagues sought to improve on previous studies of disparities in CRC screening among people with disabilities by using a statistical approach that accounts for the proportion of time individuals adhered to any combination of CRC screening recommendations.

They performed an observational study in which they reviewed South Carolina Medicaid and Medicare claims, state health plan and hospital discharge data spanning 2000-2009 to compare CRC adherence rates between individuals with the three aforementioned disabilities and those without disabilities. Adherence was defined as having undergone any one of the three preventive services at the appropriate interval recommended by the USPSTF: fecal occult blood test (FOBT) every year, sigmoidoscopy every 5 years plus an FOBT every 3 years, or a colonoscopy every 10 years.

Individuals with all three of these disabilities showed significantly lower odds of adherence to CRC screening recommendations compared with the general population; about 34% of those with an intellectual disability (adjusted OR = 0.55; 95% CI, 0.52-0.59), 44% of those with spinal cord injury (aOR = 0.88; 95% CI, 0.82-0.95) and 46% of those with blindness or low vision (aOR = 0.88; 95% CI, 0.8-0.96) reported they adhered to changing recommendations over time and received routine screenings, compared with 48% of the general U.S. population without these disabilities.

“These individuals may not be routinely screened for colorectal cancer due to a lack of education and awareness, transportation challenges or other barriers,” Deroche said in the press release. “These findings support the need for increased awareness and targeted advocacy outreach efforts to both physicians and caregivers to ensure all individuals are screened appropriately.” – by Adam Leitenberger

Disclosures: The researchers report no relevant financial disclosures.