Colorectal Cancer Screening Adherence in Selected Disabilities Over 10 Years

• Published in: American journal of preventive medicine 2017-06, Vol.52 (6), p.735-741
• Main Authors: Deroche, Chelsea B., PhD, McDermott, Suzanne W., PhD, Mann, Joshua R., MD, MPH, Hardin, James W., PhD
• Format: Article
• Language: English
• Subjects: Adherence; Adults; Aged; Blood tests; Colonoscopy; Colorectal cancer; Colorectal Neoplasms - diagnosis; Disability; Disabled Persons - statistics & numerical data; Early Detection of Cancer; Female; Humans; Injuries; Insurance Coverage - statistics & numerical data; Intellectual disabilities; Internal Medicine; Learning disabilities; Male; Mass Screening - methods; Medicaid; Medicaid - statistics & numerical data; Medical screening; Medicare; Medicare - statistics & numerical data; Middle Aged; Mortality; Sigmoidoscopy; South Carolina; Spinal cord; Spinal cord injuries; United States; Visual impairment
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2017.01.005

Introduction Colorectal cancer (CRC) is the second leading cause of cancer mortality in the U.S.; however, if the population aged 50 years or older received routine screening, approximately 60% of these deaths could be eliminated. This study investigates whether adults, aged 50–75 years, with one of three disabilities (blind/low vision [BLV], intellectual disability [ID], spinal cord injury [SCI]) receive CRC screening at rates equivalent to adults without the three disabilities, by accounting for combinations of recommended CRC screenings during a 10-year period (colonoscopy, sigmoidoscopy, fecal occult blood test). Methods South Carolina Medicaid and Medicare, State Health Plan, and hospital discharge data (2000–2009) were analyzed (2013–2015) to estimate the proportion of adherence to and adjusted odds of CRC screening over time among adults with one of the three disabilities, BLV, ID, or SCI, versus adults without these conditions. Results The estimated proportion of adults who adhere to changing recommendations over time was lower for adults with ID (34.32%) or SCI (44.14%) compared with those without these disabilities (48.48%). All three case groups had significantly lower AORs of adherence versus those without (BLV: AOR=0.88, 95% CI=0.80, 0.96; ID: AOR=0.55, 95% CI=0.52, 0.59; SCI: AOR=0.88, 95% CI=0.82, 0.95). Conclusions In this study, adults with BLV, ID, or SCI were less likely to receive and adhere to CRC screening recommendations than those without these disabilities. This method provides a thorough evaluation of adherence to CRC screening by considering levels of adherence during each month of Medicaid or Medicare coverage.