Variation in Colorectal Cancer Screening Practices According to Cardiovascular Disease Status and Race/Ethnicity

J Racial Ethn Health Disparities. 2021 Feb;8(1):166-173. doi: 10.1007/s40615-020-00768-w. Epub 2020 May 7.


Purpose: To assess current estimates of colorectal cancer (CRC) screening practices in relation to cardiovascular disease (CVD) status and whether this association varies by race/ethnicity.

Methods: Cross-sectional analysis of the Behavioral Risk Factor Surveillance System data from 2012, 2014, 2016, and 2018 among US adults aged 50-75 years (n = 807,937). Participants' self-reported CRC screening practices were categorized as being up-to-date, not up-to-date, or never screened. Multinomial logistic regression was used to assess whether self-reported prevalent CVD was associated with CRC screening practices after adjusting for several potentially confounding variables; additional analyses were stratified by race/ethnicity.

Results: One-quarter of US adults had never been screened for CRC, while 67.0% reported being up-to-date with CRC screening. The proportion of Hispanics who had never been screened (35.3%) was higher than non-Hispanic Whites (23.5%) and Blacks (20.6%). Adults with CVD were less likely to never have been screened (adjusted odds ratio (aOR), 0.92; 95% confidence interval (CI), 0.88-0.95) or not to be up-to-date (aOR, 0.90; 95% CI, 0.86-0.94) on CRC screening than those without CVD.

Conclusion: The presence of CVD is associated with better adherence to CRC screening guidelines. Poor CRC screening utilization in Hispanics should be a priority for further investigation and intervention.

Keywords: Blacks; Cardiovascular disease; Colorectal cancer screening; Hispanics; Whites.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Behavioral Risk Factor Surveillance System
  • Cardiovascular Diseases / ethnology*
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / ethnology*
  • Cross-Sectional Studies
  • Early Detection of Cancer / statistics & numerical data*
  • Ethnicity / statistics & numerical data*
  • Female
  • Healthcare Disparities / ethnology*
  • Humans
  • Male
  • Middle Aged
  • Racial Groups / statistics & numerical data*
  • United States