Factors Associated with Ever Undergoing Colorectal Cancer Testing Among Adults in the United States

There is a growing incidence of colorectal cancer and related deaths in the United States, despite screening recommendations. This study analyzed the factors associated with having ever undergone endoscopic colorectal cancer testing among adults aged 45-85 years.

This study analyzed data from the 2023 National Health Interview Survey (N = 17,087 participants). A multivariable logistic regression analysis was conducted to assess the relationship between sociodemographic and healthcare-related factors and the likelihood of having ever (a) undergone a colonoscopy or sigmoidoscopy and (b) taken a fecal immunochemical test (FIT).

The majority of the respondents had undergone an endoscopic colorectal exam (66%) vs. FIT (22%) in their lifetime. Compared to respondents aged 45-49 years, those in older age groups (50-85 years) were more likely to have ever undergone an endoscopic colorectal exam or FIT testing. African Americans were more likely to have ever undergone an endoscopic colorectal exam (Adjusted Odds Ratio (AOR) = 1.26, CI = 1.07-1.48), while American Indian/American Native and others (AOR = 1.35, CI = 1.02-1.80) were more likely to have ever undergone a FIT compared to White people. While education and health insurance were associated with having ever undergone an endoscopic colorectal exam, neither was associated with FIT. Compared to married respondents, widowed, separated, or divorced respondents (AOR = 0.88, CI = 0.79-0.98), and unmarried respondents (AOR = 0.70, CI = 0.60-0.82) were less likely to have ever undergone an endoscopic colorectal exam.

Variations in factors associated with having ever undergone endoscopic colorectal cancer testing can help to understand disparities in screening uptake better and guide the development of targeted public health interventions to improve colorectal cancer prevention and early detection.