Introduction
Colorectal cancer (CRC) is the second leading cause of cancer mortality in the U.S.;
however, if the population aged 50 years or older received routine screening, approximately
60% of these deaths could be eliminated. This study investigates whether adults, aged
50–75 years, with one of three disabilities (blind/low vision [BLV], intellectual
disability [ID], spinal cord injury [SCI]) receive CRC screening at rates equivalent
to adults without the three disabilities, by accounting for combinations of recommended
CRC screenings during a 10-year period (colonoscopy, sigmoidoscopy, fecal occult blood
test).
Methods
South Carolina Medicaid and Medicare, State Health Plan, and hospital discharge data
(2000–2009) were analyzed (2013–2015) to estimate the proportion of adherence to and
adjusted odds of CRC screening over time among adults with one of the three disabilities,
BLV, ID, or SCI, versus adults without these conditions.
Results
The estimated proportion of adults who adhere to changing recommendations over time
was lower for adults with ID (34.32%) or SCI (44.14%) compared with those without
these disabilities (48.48%). All three case groups had significantly lower AORs of
adherence versus those without (BLV: AOR=0.88, 95% CI=0.80, 0.96; ID: AOR=0.55, 95%
CI=0.52, 0.59; SCI: AOR=0.88, 95% CI=0.82, 0.95).
Conclusions
In this study, adults with BLV, ID, or SCI were less likely to receive and adhere
to CRC screening recommendations than those without these disabilities. This method
provides a thorough evaluation of adherence to CRC screening by considering levels
of adherence during each month of Medicaid or Medicare coverage.
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Article Info
Publication History
Published online: February 14, 2017
Identification
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© 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
