Individuals with certain disabilities are less likely to have recommended colorectal cancer screenings

Liz Meszaros, MDLinx | March 31, 2017

Adherence to recommended screenings for colorectal cancer are lower in individuals with certain disabilities—including low vision or blindness, intellectual disabilities, or spinal cord injuries, according to researchers from the University of Missouri School of Medicine, Columbia, MO. Their results will be published in the American Journal of Preventive Medicine.

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Low preventive CRC screening rates

Individuals with certain disabilities not routinely being screened as often as those in the general population.

“Colorectal cancer is the second leading cause of cancer deaths in the US,” said Chelsea Deroche, PhD, assistant professor of biostatistics in the MU Department of Health Management and Informatics and in the Biostatistics and Research Design Unit. “However, almost 60% of these deaths could be prevented if people ages 50 years or older received routine screenings. When studying adherence rates to recommended screenings, we found that individuals with blindness or low vision, an intellectual disability, or a spinal cord injury are less likely to receive screenings than those without these disabilities.”

Current recommendations from the US Preventive Services Task Force (USPSTF) include one of the following screening methods in individuals aged 50 to 75 years old:

  • Yearly fecal occult blood test;
  • Sigmoidoscopy every 5 years, plus a fecal occult blood test every 3 years; or
  • Colonoscopy every 10 years.

Dr. Deroche and colleagues conducted this observational study on data from the South Carolina Medicaid and Medicare clams, state health plan claims, and hospital discharge data from 2000 to 2009. They compared adherence rates with colorectal screening in individuals with blindness or low vision, an intellectual disability, or a spinal cord injury with rates in the general population.

Routine screenings were only completed by 34% of those with intellectual disabilities, 44% of those with spinal cord injuries, and 46% of those with blindness or low vision, compared with approximately 48% of the general population.

All three groups had significantly lower adjusted odds ratios (AORs) of adherence compared with those without these disabilities (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).

“These individuals may not be routinely screened for colorectal cancer due to a lack of education and awareness, transportation challenges, or other barriers,” said Dr. Deroche. “These findings support the need for increased awareness and targeted advocacy outreach efforts to both physicians and caregivers to ensure all individuals are screened appropriately.”

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