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TOPLINE:

Among US adults, unaddressed health-related social needs (HRSNs), particularly housing instability and transportation barriers, were associated with a reduced uptake of screening for colorectal cancer (CRC), with the strongest associations observed among adults aged 50-64 years.

METHODOLOGY:

• Following the US Preventive Services Task Force’s recommendation to lower the screening start age for CRC to 45 years, national studies should include younger cohorts to uncover persistent social barriers and their effects on the uptake of CRC screening.
• Researchers conducted a cross-sectional analysis of data from the 2023 National Health Interview Survey (NHIS), including 14,528 US adults aged 45-75 years (51.36% women) who were eligible for CRC screening.
• HRSNs, which are adverse social conditions that affect health outcomes, were assessed using NHIS questions about food insecurity, unstable housing, and transportation barriers, with each variable scored as either present or absent.
• The primary outcome was self-reported screening for CRC.

TAKEAWAY:

• Nearly two thirds (63.91%) of eligible adults reported being screened for CRC, with the screening rate increasing with age: 31.01% among 45- to 49-year-olds, 64.24% among 50- to 64‑year‑olds, and 80.85% among 65- to 75-year-olds.
• In the overall population, housing instability (adjusted odds ratio [aOR], 0.82; P = .04) and transportation barriers (aOR, 0.78; P = .01) were associated with lower odds of being up to date with CRC screening.
• The associations were strongest among adults aged 50-64 years: Housing instability was associated with 23% lower odds (P = .03) and transportation barriers with 29% lower odds (P = .007) of being up to date with CRC screening.
• Nearly 14.6% of adults reported at least one unmet HRSN, and even a single unmet HRSN was specifically associated with lower odds of being up to date with screening both overall and among 50- to 64-year-olds.

IN PRACTICE:

“Interventions that integrate social care into healthcare workflows and address multiple barriers simultaneously may help reduce persistent disparities in CRC screening and outcomes,” the authors of the study concluded.

SOURCE:

The study was led by Aldenise P. Ewing, PhD, MPH, The Ohio State University College of Public Health, Columbus, Ohio. It was published online in JAMA Network Open.

LIMITATIONS:

This study was limited by its cross-sectional design and reliance on self-reported HRSNs and CRC screening. Additionally, important factors, such as health literacy, practitioner communication quality, and social support, were not included.

DISCLOSURES:

The study was partly supported by a grant from the National Cancer Institute. One author reported writing articles on CRC screening for UpToDate.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.