Predictors of Colorectal Cancer Screening Rates in Federally Qualified Health Centers: Explicating Organizational...

Area of Science:

• Public Health
• Health Services Research
• Cancer Prevention

Background:

• Colorectal cancer (CRC) screening is crucial for early detection and improved patient outcomes.
• Federally Qualified Health Centers (FQHCs) serve vulnerable populations and play a vital role in public health initiatives.
• Understanding organizational factors influencing CRC screening rates within FQHCs is essential for targeted interventions.

Purpose of the Study:

• To analyze temporal trends in CRC screening rates within US FQHCs from 2017 to 2022.
• To identify organizational-level factors associated with changes in CRC screening rates.
• To inform strategies for enhancing CRC screening uptake in underserved communities.

Main Methods:

• Longitudinal analysis of Uniform Data System (UDS) data from 1282 US FQHCs (2017-2022).
• Mixed-effects models were employed to assess the impact of organizational factors on CRC screening rates.
• Key factors examined included Patient-Centered Medical Home (PCMH) recognition, chronic disease management, and center characteristics.

Main Results:

• CRC screening rates increased pre-pandemic but declined and have not recovered to pre-pandemic levels.
• Consistent PCMH recognition was significantly associated with higher CRC screening rates (β=8.50, p<0.001).
• Higher rates of controlled hypertension correlated positively with screening (β=0.354, p<0.0001), while larger Black patient populations, Southern locations, and smaller center sizes were associated with lower rates.

Conclusions:

• Sustained Patient-Centered Medical Home recognition and effective chronic disease management are critical for boosting CRC screening in FQHCs.
• Integrating population health strategies can help FQHCs mitigate screening disparities.
• Prioritizing these organizational approaches can advance health equity and broaden access to CRC screening for marginalized groups.