Abstract PO-237: Colorectal cancer screening in patients with type 2 diabetes mellitus
Authors: Xia Helen Y. , Lu Wenyue 
Published: December 2020

Abstract
Background: The prevalence of type 2 diabetes mellitus and colorectal cancer (CRC) have dramatically increased over the past 20 years. Studies provide evidence that type 2 diabetes is associated with an increased risk of developing CRC. The risk of CRC is estimated to be 27% higher in patients with type 2 diabetes mellitus than in non-diabetic people. Although CRC screening is the most important measure in detection of precancerous polyps and subsequent early stage cancer, studies investigating CRC screening behavior among diabetic patients of racial/ethnic minority populations have been limited. Method: This study uses a sample of 275857 adults age 50 and older completing the 2018 BRFSS national survey (BRFSS-2018), which includes five racial and ethnic groups (White 84%, Black 8%, American Indian 2%, Hispanic 1%, and Asian 5% populations). Our main variables include demographic/social economic factors, diabetes management indicators (such as physical activity, smoking, compliance of recommended doctor office visits, feet, eyes and blood sugar monitoring) and CRC screening. Chi square test is conducted to detect the CRC screening among different racial/ethnic groups. A p value smaller than 0.05 is considered significant. Results: Overall, the BRFSS-2018 data still revealed a lower rate (74%) of CRC screening when compared to the national 2018 goal of 80% screened for CRC. American Indian reported the lowest screening rate (58%), followed by Hispanic (59%), Asian (63%), Black (72%) and White (76%). People with diabetes were more likely to complete CRC screening compared to people without diabetes across all racial/ethnic groups (total group: 77% vs 74%; White 79% vs76%; Black 77% vs 71%; Asian 69% vs 61%; American Indian 61% vs 57%; Hispanic 63% vs 58%). In general, non-smokers reported a significantly higher CRC screening rate compared with smokers (78.67% vs 59.39%, p&lt;0.001); among smokers, people with diabetes had significantly higher CRC screening rate than those without diabetes (66.79% vs 57.75%). With regard to physical activities (PA), those who did exercises in the past 30 days were more likely to have CRC screening than those who did not (75.91% vs 70.22%, p&lt;0.001); among those who did not do exercises, people with diabetes were significantly more likely to complete the CRC screening (74.04% vs 68.83%, p&lt;0.001). In addition, the association between CRC screening and diabetes management measures was examined. People checked their feet (78.20% vs 70.71%, p&lt;0.001) or eyes (79.93% vs 67.22%, p&lt;0.001) by health professionals over past year reported significantly higher CRC screening rates than those who did not. However, doctor’s visits for diabetes, daily blood sugar checking, and A1C test frequency were not significantly associated with CRC screening. Conclusion: Patient education on risk of diabetes towards CRC and CRC screening should be integrated in diabetes management. CRC screening intervention incorporating patient engagement may be warranted for both the diabetes and general population.
Citation Format: Helen Y. Xia, Wenyue Lu. Colorectal cancer screening in patients with type 2 diabetes mellitus [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-237.