Abstract A100: Associations of multiple chronic conditions and colonoscopy utilization among different race/ethnic groups: BRFSS 2012-2020
Authors: Castaneda-Avila Maira A. , Epstein Mara M. , Tisminetzky Mayra , Oyinbo Atinuke G. , Lapane Kate L. 
Published: January 2023

Background: Colorectal cancer (CRC) is the 4th most commonly diagnosed cancer and the 4th cause of cancer-related death in the U.S. Early detection of CRC through routine screening has been associated with decreasing CRC mortality. Because many chronic conditions share risk factors with CRC, the importance of CRC screening in adults with multiple chronic conditions (MCC) is increased as those with MCC are at higher risk of developing CRC. This study examines the association of number and types of chronic conditions (individual, dyads, and triads) with the receipt of colonoscopy and whether this association differs across race/ethnic groups. Methods: We conducted a cross-sectional analysis of 976,467 adults aged 50-74 years in the US Behavioral Risk Factor Surveillance System (2012-2020). Self-reported receipt of last/most recent colonoscopy was categorized as never, &lt;10 years and ≥10 years. MCC was calculated using counts of 12 chronic conditions (obesity, arthritis, diabetes, smoking, depression, binge drinking, cardiovascular diseases (CVD), asthma, chronic obstructive pulmonary disease (COPD), kidney disease, cancer, skin cancer) and categorized as none, 1, 2, ≥3 conditions. The most common chronic condition dyads and triads were assessed. A logistic model was used to quantify the association between MCC and the receipt of colonoscopy adjusted for sex, age, and health care insurance status; additional analyses were stratified by race/ethnicity. All results were weighted to be representative of the broader population of U.S. adults aged 50 – 74 years using standard BRFSS weights. Results: Over half the sample were women (52.5%), 72.4% non-Hispanic white, and 62.8% had a colonoscopy in previous 10 years. Nearly one-third had ≥3 MCC (32.6%) and 23.1% had two MCC. Participants with ≥3 MCC were more likely to have had a colonoscopy in ≤10 years (adjusted odds ratio [aOR]: 1.28; 95% confidence interval [CI]: 1.24–1.32) than those without MCCs, regardless of race/ethnicity. Participants with the triad of smoking, binge drinking, and CVD were less likely to have had a colonoscopy within 10 years (aOR: 0.65; 95%CI: 0.54–0.78) than those without this MCC triad. The association between different combinations of MCC and colonoscopy utilization varied by race/ethnicity. Among those with the smoking/binge drinking/CVD triad, non-Hispanic Blacks (aOR: 0.59; 95%CI: 0.39–0.90) and US Hispanics (aOR: 0.28; 95%CI: 0.10–0.74) participants were less likely to have had a colonoscopy within 10 years than participants without this triad and identified with the same race/ethnic group. Conclusion: MCCs are common among adults aged 50-74 years. The MCC triad of smoking, binge drinking, and CVD was associated with a lack of colonoscopy adherence recommendation, and adults identified as non-Hispanic Blacks and US Hispanics with this triad were even less likely to receive a colonoscopy within 10 years. This finding may help health care providers and systems to identify patients at higher risk of CRC and non-adherent to cancer screening recommendations.

Citation Format: Maira A. Castaneda-Avila, Mara M. Epstein, Mayra Tisminetzky, Atinuke G. Oyinbo, Kate L. Lapane. Associations of multiple chronic conditions and colonoscopy utilization among different race/ethnic groups: BRFSS 2012-2020 [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A100.