Abstract A121: Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors
Authors: Tsai Meng-Han , Moore Justin X. , Odhiambo Lorriane , Andrzejak Sydney E. , Tingen Martha S. 
Published: January 2023

Abstract
Background: Advancement in cancer detection and treatment has improved survival rates leading to a growing population of cancer survivors, yet cancer survivors are at a 20% increased risk of developing a secondary cancer. Breast, cervical, prostate, and lung cancer survivors as well as malignant melanoma survivors have been reported an increased risk for developing colorectal cancer (CRC). Although receiving appropriate cancer screening for secondary cancers is recommended, evidence on CRC screening among different cancer survivors are lacking. Methods: We examined the relationship between sociodemographic characteristics, access to care, risk behavior factors, and chronic health conditions in cancer survivors, with up-to-date CRC screening utilization (colonoscopy, flexible sigmoidoscopy, fecal occult blood test) among breast, cervical, prostate, skin (including melanoma), and lung cancer survivors, using data from the 2020 Behavioral Risk Factor Surveillance System. Descriptive statistics were used to summarize the data and multivariable logistic regressions were applied to assess the association of these characteristics with up-to-date CRC screening use. Results: Among 9,780 cancer survivors included in the analysis, most were age 60-69 years, had first cancer at 41-59 years, were Non-Hispanic White, and had some college or college graduate education. Compared to CRC screening rates in breast, prostate, skin, and lung cancer survivors, cervical cancer survivors had a lower rate of screening at 65% (breast cancer: 82%, prostate cancer: 88%, skin cancer: 78%, and lung cancer: 80%). In multivariable analysis, breast, cervical, and skin cancer survivors aged ≥ 60 years were associated with higher odds of receiving CRC screening compared to adults aged 45-59 years (p-value &lt;0.05). Respondents that had their last routine checkup two or more years prior, had lower odds of having CRC screening among cervical (OR=0.06; 95% CI, 0.02-0.22), prostate (OR=0.26; 95% CI, 0.14-0.49), and skin cancer (OR=0.50; 95% CI, 0.36-0.70) survivors. The presence of one or more chronic diseases were associated with higher odds of having up-to-date CRC screening among breast, prostate, and skin cancer survivors; however, lung cancer survivors with one or two chronic diseases exhibited lower odds of receiving CRC screening (OR=0.16; 95% CI, 0.04-0.61) compared to respondents without chronic disease. Conclusion: Findings from this study provide important evidence on factors that may be associated with up-to-date CRC screening use across different cancer survivors which include older age, routine checkup, and multiple chronic diseases. Moreover, variations of CRC screening utilization among cancer survivors may highlight missed opportunities for secondary cancer prevention. These findings will inform the importance of secondary cancer prevention in survivorship care plans for breast, cervical, prostate, skin, and lung cancer survivors and effective implementation of these plans through primary health care initiatives.
Citation Format: Meng-Han Tsai, Justin X. Moore, Lorriane Odhiambo, Sydney E. Andrzejak, Martha S. Tingen. Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors [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 A121.