Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services Administration
Introduction: Federally qualified health centers provide primary care services to millions of low-income patients in the United States who face challenges accessing colorectal cancer (CRC) screening. We aimed to understand how patient-level factors influence CRC screening participation and screening...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Preventive Medicine Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335525000154 |
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| author | Megan R.M. Aaronson Nadereh Pourat Connie Lu Jayraan Badiee Helen Yu-Lefler Benjamin Picillo Hank Hoang Folasade P. May |
| author_facet | Megan R.M. Aaronson Nadereh Pourat Connie Lu Jayraan Badiee Helen Yu-Lefler Benjamin Picillo Hank Hoang Folasade P. May |
| author_sort | Megan R.M. Aaronson |
| collection | DOAJ |
| description | Introduction: Federally qualified health centers provide primary care services to millions of low-income patients in the United States who face challenges accessing colorectal cancer (CRC) screening. We aimed to understand how patient-level factors influence CRC screening participation and screening modality choice in this setting. Methods: We examined data from the 2022 Health Center Patient Survey, 2021 Uniform Data System, and Area Health Resource File. We performed generalized multilevel logistic regression and multinomial regression to measure associations between our independent variables and receipt of any CRC screening and of screening modalities. Results: Among 1584 patients ages 50–75, most (56 %) reported having CRC screening, including 33 % with endoscopic screening only, 16 % with stool-based screening only, and 7 % with multiple modalities. Selected factors associated with any CRC screening included having five or more health center visits in the past year (aOR = 1.66, 95 %CI = 1.07–2.56), being insured (Medicaid aOR = 2.25, 95 %CI = 1.44–3.54; other insurance aOR = 2.69, 95 %CI = 1.51–4.82), living within 30 minutes of the health center (aOR = 1.93, 95 %CI = 1.15–3.25), having multiple comorbidities (aOR = 1.72, 95 %CI = 1.13–2.63), using telehealth (aOR = 1.52, 95 %CI = 1.02–2.27), and having a flu shot last year (aOR = 1.77, 95 %CI = 1.29–2.45). We observed that patients who are non-Hispanic Black (aOR = 3.52, 95 %CI = 1.28–9.68) and who do not speak English well or at all (aOR = 5.54, 95 %CI = 1.64–18.75) reported having multiple modalities. Conclusion: Federally qualified health center patients reported endoscopic CRC screening more commonly than stool-based screening, and barriers to access such as distance to the health center and English proficiency were impactful. Increasing CRC screening in low-income populations requires improving access and promoting opportunities for less invasive screening. |
| format | Article |
| id | doaj-art-16e633d7a4584499b8a2b249bab66b5a |
| institution | Kabale University |
| issn | 2211-3355 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj-art-16e633d7a4584499b8a2b249bab66b5a2025-02-08T05:00:17ZengElsevierPreventive Medicine Reports2211-33552025-02-0150102976Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services AdministrationMegan R.M. Aaronson0Nadereh Pourat1Connie Lu2Jayraan Badiee3Helen Yu-Lefler4Benjamin Picillo5Hank Hoang6Folasade P. May7Fellow in Gastroenterology, UCLA Division of Digestive Diseases, UCLA, Los Angeles, CA, USAUCLA Center for Health Policy Research, Los Angeles, CA, USA; UCLA Fielding School of Public Health, Department of Health Policy and Management, USAUCLA Center for Health Policy Research, Los Angeles, CA, USAVatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USABureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USAAt the time of writing, the author was employed at HHS, HRSA, BPHC; currently at CMS, Center for Medicare and Medicaid Innovation, USABureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USAVatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA; Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA; UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA; Corresponding author at: UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095-6900, USA.Introduction: Federally qualified health centers provide primary care services to millions of low-income patients in the United States who face challenges accessing colorectal cancer (CRC) screening. We aimed to understand how patient-level factors influence CRC screening participation and screening modality choice in this setting. Methods: We examined data from the 2022 Health Center Patient Survey, 2021 Uniform Data System, and Area Health Resource File. We performed generalized multilevel logistic regression and multinomial regression to measure associations between our independent variables and receipt of any CRC screening and of screening modalities. Results: Among 1584 patients ages 50–75, most (56 %) reported having CRC screening, including 33 % with endoscopic screening only, 16 % with stool-based screening only, and 7 % with multiple modalities. Selected factors associated with any CRC screening included having five or more health center visits in the past year (aOR = 1.66, 95 %CI = 1.07–2.56), being insured (Medicaid aOR = 2.25, 95 %CI = 1.44–3.54; other insurance aOR = 2.69, 95 %CI = 1.51–4.82), living within 30 minutes of the health center (aOR = 1.93, 95 %CI = 1.15–3.25), having multiple comorbidities (aOR = 1.72, 95 %CI = 1.13–2.63), using telehealth (aOR = 1.52, 95 %CI = 1.02–2.27), and having a flu shot last year (aOR = 1.77, 95 %CI = 1.29–2.45). We observed that patients who are non-Hispanic Black (aOR = 3.52, 95 %CI = 1.28–9.68) and who do not speak English well or at all (aOR = 5.54, 95 %CI = 1.64–18.75) reported having multiple modalities. Conclusion: Federally qualified health center patients reported endoscopic CRC screening more commonly than stool-based screening, and barriers to access such as distance to the health center and English proficiency were impactful. Increasing CRC screening in low-income populations requires improving access and promoting opportunities for less invasive screening.http://www.sciencedirect.com/science/article/pii/S2211335525000154Colorectal cancer screeningPatient surveysHealth centersHealth disparitiesAccess to healthcare |
| spellingShingle | Megan R.M. Aaronson Nadereh Pourat Connie Lu Jayraan Badiee Helen Yu-Lefler Benjamin Picillo Hank Hoang Folasade P. May Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services Administration Preventive Medicine Reports Colorectal cancer screening Patient surveys Health centers Health disparities Access to healthcare |
| title | Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services Administration |
| title_full | Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services Administration |
| title_fullStr | Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services Administration |
| title_full_unstemmed | Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services Administration |
| title_short | Predictors of Colorectal Cancer Screening and Screening Modalities among Patients seen at Federally Qualified Health Centers Funded by the United States Health Resources and Services Administration |
| title_sort | predictors of colorectal cancer screening and screening modalities among patients seen at federally qualified health centers funded by the united states health resources and services administration |
| topic | Colorectal cancer screening Patient surveys Health centers Health disparities Access to healthcare |
| url | http://www.sciencedirect.com/science/article/pii/S2211335525000154 |
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