Association Between Patient-Provider Relationship Quality and Colorectal Cancer Screening Uptake Among US Adults

Patient-provider relationship (PPR) quality may influence colorectal cancer (CRC) screening uptake, yet national-level evidence remains limited. This study examined the association between PPR quality and CRC screening among US adults. This retrospective cross-sectional study used nationally representative data from the Health Information National Trends Survey (HINTS) 2018-2020 cycles. The analytic sample included 7,732 adults aged 45-75 years. Weighted descriptive analyses, chi-square tests, and multivariable logistic regression were conducted. Overall, 5,771 (76.2%) participants reported ever having completed a CRC screening test. Screening prevalence was 75.5% (n = 3,999) during the pre-COVID period and 77.9% (n = 1,772) during the COVID period. Screening uptake was lowest among adults aged 45-54 years (n = 908, 47.7%), compared with adults aged 55-64 years (n = 2,252, 81.7%) and 65-75 years (n = 2,611, 89.6%). Most respondents reported high PPR quality (n = 5,248, 82.8%). After adjustment, lower PPR quality was associated with reduced CRC screening uptake (adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI): 0.59-0.86). Lower emotional support (aOR = 0.72, 95% CI: 0.59-0.89) and reduced shared decision-making (aOR = 0.71, 95% CI: 0.56-0.89) were also associated with decreased screening uptake. Asian (aOR = 0.39, 95% CI: 0.17-0.87) and Hispanic (aOR = 0.34, 95% CI: 0.22-0.53) respondents reported lower PPR quality than non-Hispanic Whites. Lower PPR quality was associated with decreased CRC screening uptake. Strengthening supportive and culturally responsive patient-provider interactions may improve CRC screening participation and reduce disparities in preventive cancer care.