Colorectal Cancer Screening and Social Needs

Area of Science:

• Public Health
• Preventive Medicine
• Health Disparities

Background:

• Colorectal cancer (CRC) is a leading cause of cancer death in the U.S.
• Patient-reported barriers to CRC screening are known, but the impact of social needs is less understood.
• Few studies have analyzed how social needs influence CRC screening rates.

Purpose of the Study:

• To investigate the association between patients' social needs and their adherence to colorectal cancer (CRC) screening guidelines.
• To identify specific social needs that act as barriers to CRC screening completion.
• To inform strategies for improving CRC screening rates by addressing social determinants of health.

Main Methods:

• Cross-sectional study of 3,443 Kaiser Permanente patients aged 50-75 years.
• Assessed five social needs categories: financial strain, housing instability, transportation issues, social isolation, and food insecurity.
• Determined CRC screening status using electronic health records based on Health care Effectiveness Data and Information (HEDIS) criteria; analyzed associations using multivariable analyses.

Main Results:

• 81.5% of patients were up to date on CRC screening.
• Severe financial strain (OR 2.1), social isolation (OR 1.9), and food insecurity (OR 2.5) were significantly associated with lower odds of being up to date on screening.
• Severe transportation issues and housing instability showed non-significant trends towards lower screening rates.

Conclusions:

• Social needs, including financial strain, social isolation, and food insecurity, are linked to lower CRC screening rates, even in fully insured individuals.
• Addressing social determinants of health is essential for enhancing CRC screening adherence.
• Future research should explore interventions targeting social needs to improve CRC screening.