Vulnerability and Colorectal screening during the pandemic.

Area of Science:

• Public Health
• Epidemiology
• Health Equity

Background:

• Colorectal cancer (CRC) screening disparities exist across US neighborhoods, potentially due to social inequities.
• Neighborhood social vulnerability may create barriers to accessing and completing preventive health services like CRC screening.

Purpose of the Study:

• To determine if neighborhood social vulnerability was associated with changes in CRC screening prevalence in Boston during the COVID-19 pandemic.
• Investigate the impact of the pandemic on CRC screening rates in relation to the Social Vulnerability Index (SVI).

Main Methods:

• Analysis of CRC screening data for adults aged 50-74 years from 35 primary care practices in Boston, MA.
• Utilized the Social Vulnerability Index (SVI) to assess neighborhood-level social factors.
• Compared screening prevalence from March 2020 to March 2022.

Main Results:

• Overall CRC screening prevalence decreased from 74.9% in 2020 to 67.4% in 2022 (p < 0.001).
• No significant association was found between the change in screening prevalence and SVI.
• Screening decreased by 5.5% in lower SVI neighborhoods versus 3.6% in higher SVI neighborhoods (p = 0.79).

Conclusions:

• The COVID-19 pandemic temporarily equalized CRC screening prevalence across Boston-area neighborhoods, despite pre-existing disparities.
• Strategies promoting equitable CRC screening participation are crucial for pandemic recovery and health equity.