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

UMMS Affiliation

Department of Population and Quantitative Health Sciences; Graduate School of Nursing; Meyers Primary Care Institute; Department of Medicine

Publication Date


Document Type



Analytical, Diagnostic and Therapeutic Techniques and Equipment | Clinical Epidemiology | Digestive System Diseases | Epidemiology | Health Services Administration | Neoplasms | Translational Medical Research


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.


Cardiovascular disease, Colorectal cancer screening, Hispanics, Blacks, Whites, UMCCTS funding

DOI of Published Version



Castañeda-Avila MA, Lapane KL, Jesdale BM, Crawford SL, Epstein MM. 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. PMID: 32383046; PMCID: PMC7647945. Link to article on publisher's site

Journal/Book/Conference Title

Journal of racial and ethnic health disparities

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