Colorectal Cancer Screening Rates Low Among Breast and Prostate Cancer Survivors in Single Center Study

Patients who survived breast or prostate cancer had a low rate of colorectal cancer (CRC) screenings, with factors such as gender, comorbidities, and residence being associated with receiving a screening, according to findings from a single center study based in Southern Maryland.

Results from the study indicated that, overall, 51% of survivors received a colonoscopy for CRC, including 54% of prostate and 44% of breast cancer survivors. Some factors such as being older than 65 years, surviving breast cancer vs prostate cancer, and living in a large vs small metropolitan area were associated with lower odds of undergoing a screening for CRC. Notably, survivors with hypertension were associated with consistently being screened for CRC were, whereas those with diabetes and obesity were not associated with undergoing screening.

“CRC screening rates remain low among breast and prostate cancer survivors with existing disparities observed based on gender and geographic area of residence. In addition, certain comorbidities are associated with increased adherence to colonoscopy screening and future studies should examine the mechanisms associated with these findings. Our findings suggest the importance of secondary cancer prevention in survivorship care plans for [patients with] breast and prostate cancer and effective implementation of such plans within the primary care system,” the investigators wrote.

A total of 1947 cancer survivors were included in the study, 1056 of whom had breast cancer and 891 had prostate cancer. The mean patient age was 71.22 years and 30% of patients were 75 years or older. Prostate cancer patients were an average of 4 years older than breast cancer patients. In the overall population, 57% of survivors were non-Hispanic White, and 30% were non-Hispanic Black. Moreover, 58% of patients reported living in a large metropolitan area vs 42% who lived in a small metropolitan area.

Findings from a multivariate model indicated that those living in small areas were 3.62 times more likely to have a CRC screening than survivors residing in large areas (95% CI, 2.93-4.47). Patients with hypertension were 2 times or more likely to receive CRC screenings than those without the comorbidity (OR, 2.12; 95% CI, 1.67-2.69); the association was higher for those who survived breast cancer vs prostate cancer. Those living in small metropolitan areas who survived breast cancer were 5 times as likely to be screened for CRC than those in larger areas (95% CI, 3.90-7.05); this association was less notabe among patients who survived prostate cancer (OR, 2.36; 95% CI, 1.20-2.54).

Patients who were non-Hispanic Black and survived prostate cancer who resided in large metropolitan areas were 48% as likely to have CRC screenings compared with non-Hispanic White patients (95% CI, 1.03-2.13). In patients who survived breast and prostate cancer and were diagnosed with hypertension, screenings were 2 times more likely to take place compared with those who did not have hypertension who lived in large metropolitan areas (95% CI, 1.55-3.10) and small metro areas (95% CI, 1.50-2.96).

This study was repeated with patients under 75 years of age. Investigators found similar results except for age and race, which were not associated with receipt of CRC screening. Moreover, race was not associated screening for those in large or small metropolitan areas.

Reference

Dash C, Lu J, Parikh V, et al. Disparities in colorectal cancer screening among breast and prostate cancer survivors. Cancer Med. 2021;10(4):1448-1456. doi:10.1002/cam4.3729