Colorectal Cancer Screening Disparities Among Race: A Zip Code Level Analysis

Area of Science:

• Public Health
• Health Disparities
• Cancer Prevention

Background:

• Colorectal cancer (CRC) screening is crucial for early detection and disease prevention.
• Existing CRC screening disparities are linked to race, socioeconomic status, insurance, and geography.
• Social determinants within zip code tabulation areas significantly influence CRC screening rates.

Purpose of the Study:

• To investigate the impact of social determinants, specifically the social deprivation index (SDI), on colorectal cancer (CRC) screening rates at a zip code level.
• To analyze the association between race, socioeconomic factors, and CRC screening.
• To identify key social barriers affecting CRC screening uptake.

Main Methods:

• Retrospective cross-sectional study of CRC screenings by race at zip code level.
• Utilized data from CDC 500 Cities Project, PLACES Project, and American Community Survey.
• Conducted multivariate and confirmatory factor analyses including SDI, race, income, insurance, and check-up visits.

Main Results:

• Higher SDI tertiles correlated with increased likelihood of being Black or Hispanic and lower median household income.
• Lower rates of regular check-ups were observed in the highest SDI tertile.
• Being Black, Hispanic, lower income, uninsured, lacking regular check-ups, and higher SDI were associated with decreased CRC screening; SDI and insurance access were most impactful.

Conclusions:

• The social deprivation index (SDI) and healthcare access are the primary factors influencing local CRC screening rates.
• Findings highlight the need for interventions targeting social barriers to enhance CRC screenings in disadvantaged communities.
• Improving early CRC detection through addressing social determinants can reduce overall mortality.