Association of physical activity, self-reported health, and endoscopic colorectal screening among US adults age...

Early detection of colon cancer through screening is critical for improving long-term survival outcomes; however, only 54 % of the United States (U.S.) population that is eligible to have a colon cancer screening receive one. Previous research found that people who participate in physical activity (PA) are less likely to get screened due perception of having low risk. However, health organizations have lowered the age to initiate screening as more cases are being reported among younger U.S. residents.

This study aimed to examine the association between colon cancer screening and self-reported health status for individuals meeting aerobic PA guidelines among individuals aged 45-54.

We conducted a cross-sectional analysis of the 2023 Behavioral Risk Factor Surveillance System (BRFSS) data. We included all participants between the ages of 45 and 54 who responded to the questionnaire regarding colonoscopy and sigmoidoscopy examinations, and the supplementary module that features PA and sedentary behaviors.

Among 1118 respondents, 503 (45.5 %) reported having undergone colon cancer screening via colonoscopy or sigmoidoscopy, whereas 615 (54.5 %) had not. Screening prevalence differed by insurance status (p=0.002), with higher rates among insured individuals (483/1034; 47.2 %) compared with uninsured individuals (11/65; 19.2 %). Screening also varied by race/ethnicity (p=0.022); rates were highest among White respondents (353/732; 49.9 %) and lowest among Asian respondents (16/60; 27.3 %). Screening did not significantly differ by education, sex, overweight/obesity status, transportation access, place of residence, or PA status (all p>0.05). Among respondents meeting aerobic PA guidelines (n=1048), 489 (47.0 %) reported screening. Neither cardiovascular disease (CVD) risk (adjusted odds ratio [AOR]=1.22, 95 % confidence interval [CI]: 0.87-1.70) nor self-reported good health (AOR=0.89, 95 % CI: 0.52-1.51) was associated with screening. Among those meeting both aerobic and strength training guidelines (n=541), 255 (48.8 %) reported screening. In this group, reporting good or better health was associated with lower odds of screening (AOR=0.37, 95 % CI: 0.15-0.90), while CVD risk remained nonsignificant (AOR=1.33, 95 % CI: 0.80-2.23).

Our analysis found no link between colon cancer screening and self-reported health status for those meeting aerobic guidelines, but those who met both aerobic and strength training guidelines were less likely to get screened. Uninsured individuals and Asian Americans also had lower screening rates. These findings highlight the need for targeted public health campaigns to address screening disparities, particularly among active individuals and underserved communities.