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2023-03-06
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Copyright (c) 2023 Katherine Bromm, Antoinette B. Coe, Sarah E. Vordenberg
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright of content published in INNOVATIONS in pharmacy belongs to the author(s).
The Impact of Rurality and Age on Colorectal Cancer Screening Among Michigan Residents
Katherine Bromm
University of Michigan College of Pharmacy
Antoinette B. Coe
University of Michigan College of Pharmacy
Sarah E. Vordenberg
University of Michigan College of Pharmacy
DOI: https://doi.org/10.24926/iip.v14i1.5212
Keywords: Behavioral risk factor surveillance system, colorectal cancer, cancer prevention, pharmacist
Abstract
Background: Colorectal cancer (CRC) is a prevalent cause of cancer-related deaths in Michigan, but not all Michigan adults had appropriate CRC screening.
Objective: To assess the relationship between rurality and age on CRC screenings to inform how pharmacists could focus their efforts to educate, facilitate, or offer CRC health screenings.
Methods: This was a retrospective, cross-sectional study using 2018 Michigan Behavioral Risk Factor Surveillance System (MiBRFSS) survey data. Michigan participants aged ≥ 50 years were included. Outcomes included the utilization of stool-based tests, sigmoidoscopies, colonoscopies, and the most recent CRC screening. Demographic variables included age, sex, income, race/ethnicity, relationship status, education level, employment status, income, rurality, and health insurance. Representative sampling weights
were used to adjust for the complex survey design. Descriptive statistics, chi-square, and multivariable logistic regression analyses were conducted. IBM SPSS version 28.0.1.0 was used and an a priori p-value of <0.05 was deemed significant.
Results: A weighted total of 3,762,540 participants were included, of which 21.3% (n = 781,907) reported living in a rural area and approximately 70% (n = 2,616,646) were between the ages of 50-69 years old. Most participants reported being White, non-Hispanic (n = 3,104,117, 84.5%), having health insurance (n = 3,619,801, 96.4%), and having a colonoscopy (74.6%, n= 2,620,581). There was no difference based on rurality. Compared to those aged 50-59 years, adults 60-69 years (AOR = 1.97, 95% CI: 1.58,2.45), 70-79 years (AOR = 3.29, 95% CI: 2.40,4.51), and ≥ 80 years (AOR = 2.23, 95% CI: 1.54,3.24) had higher odds of receiving a colonoscopy. Lack of insurance was associated with lower odds of receiving a colonoscopy (AOR = 0.38, 95% CI: 0.23, 0.56).
Conclusion: Most participants reported having a CRC screening but efforts to increase CRC screening in Michigan adults aged 50-59 are warranted.
