Relationship between Chronic Disease Conditions and Colorectal Cancer Screening: Results from the 2012 National Health Interview Survey Data

Background: Uptake of screening remains crucial in the prevention of both the incidence of colorectal cancer (CRC) and its mortality.Objectives: To estimate the prevalence of CRC screening and identify chronic conditions that predict CRC screening uptake among US adults using the 2012 National Health Interview Survey (NHIS) data.Materials and Methods: A cross-sectional analysis of the 2012 NHIS data. Chronic conditions examined were hypertension, cancer history, arthritis, ulcer, and high cholesterol level. A total of 21,511 participants were included in the analysis. Weighted univariate and multiple logistic regression analyses in SAS ver. 9.2 were used to estimate the odds ratios (ORs) with 95% confidence intervals (CIs).Results: The overall prevalence of CRC screening was 19%. The prevalence of CRC screening in adults with cancer history, hypertension, ulcer, high cholesterol, and arthritis was significantly higher than those without the chronic conditions (26% vs.18%, 23% vs.16%, 25% vs.18%, 23% vs. 16%, and 23% vs. 17%, respectively). After adjusting for potential factors, hypertension (OR=1.18, 95%CI=1.08-1.30), ulcer (OR=1.28, 95%CI=1.10-1.48), high cholesterol (OR=1.25, 95%CI=1.14-1.39), and arthritis (OR=1.24, 95%CI=1.12-1.37) were all positively associated with CRC screening (p0.05). Females were less likely to screen for CRC than to males (OR=0.72; 95% CI=0.65-0.80). Compared to young adults (18-44 years), screening was significantly higher in middle-aged (45-64 years) and elder adults (65+) (OR=2.60, 95%CI=2.11-3.21 and OR=2.67, 95%CI=2.13-3.33, respectively). African Americans were more likely to screen for CRC compared to their white counterparts (OR=1.61, 95% CI=1.44-1.81). Conclusions: We have found significant associations between chronic conditions and CRC screening uptake. We also found higher uptake of CRC screen in African Americans than Whites, in contrast to earlier findings