US women screen at lower rates for both cervical and colorectal cancers than a single cancer
Abstract
Introduction
Using screen counts, women 50-64 yo have lower cancer screening rates for cervical and colorectal cancers compared to all other age ranges. The primary aim of this paper is to present cervical cancer and CRC screenings per woman and determine the predictors of being up-to-date for both.
Methods
We used the Behavioral Risk Factor Surveillance System (BRFSS), an annual survey to guide health policy in the US, to explore the up-to-date status of dual cervical and colorectal cancer screening for women 50-64 yo. We categorized women into four mutually exclusive categories: up-to-date for dual screening, each single-screen, or neither screen. Multinomial multivariate regression modeling was used to evaluate the predictors of each category.
Results
Among women ages 50-64 yo, dual screening was reported for 58.7% (57.6-59.9), cervical cancer screening alone (27.0% (25.9-28.1), CRC screening alone (5.3% (4.8-5.8), and neither screen (9% (8.4-9.6). Age, race, education, income, and chronic health conditions were significantly associated with dual screening compared to neither screen. Hispanic women compared to non-Hispanic White women were more likely to be up-to-date with cervical cancer screening than dual screening (aOR 1.38 (1.08, 1.77). By comparison to younger women, those 60-64 years are significantly more likely to be up-to-date with CRC screening than dual screening (aOR 1.75 (1.30, 2.34)).
Conclusions
Screening received by each woman shows a much lower rate of dual screening than prior single cancer screening rates. Addressing dual screening strategies rather than single cancer screening programs for women 50-64 years may increase both cancer screening rates.
Graphical Abstract
Screening rates differ by calculation approach. A better population metric for cancer prevention is to consider the screens each woman has received. Our data show much lower cervical cancer and CRC screening rates than a single screen calculation.
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Women 50-64 years old lack dual cervical and colorectal cancer screening. Women who screen for only one cancer of the two, screen for cervical cancer almost five times more often than colorectal cancer.
Lay Summary
Routine cervical and colorectal cancer (CRC) screenings can detect early, treatable, curable cancers. Using the responses to the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS) we approached prevention by what the woman has received rather than by how many screens were done. We showed that women 50-64 years old were only up-to-date for both cervical and CRC screening 59% of the time, whereas, by traditional screening calculations, our data showed 86% of women were up-to-date for cervical cancer screening and 64% were up to date with CRC screening, irrespective of any other cancer screenings.
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