Patients with comorbidities were more likely to undergo screening for colorectal cancer (CRC) than those without comorbidities, according to an analysis published in the Journal of Osteopathic Medicine.
Using the 2018 and 2019 Behavioral Risk Factor Surveillance System (BRFSS), researchers identified patients with and without comorbid conditions and compared CRC screening rates between the 2 groups. BRFSS is a survey in which respondents from the United States, Guam, and Puerto Rico voluntarily provide health information.
A total of 279,784 patients were identified, of whom 222,879 (79.7%) underwent CRC screening.
Compared with patients who did not have comorbidities, those with the following comorbidities had a greater likelihood of being screened for CRC: diabetes, hypertension, skin cancer, chronic obstructive pulmonary disease, arthritis, depression, and chronic kidney disease.
Patients with 1 comorbidity had a significantly higher likelihood of being screened for CRC compared with patients without comorbidities (adjusted risk ratio [ARR]=1.11; 95% CI, 1.09-1.12). Patients with 2 to 4 comorbidities had a similar, significantly higher likelihood of being screened for CRC (ARR=1.2; 95% CI, 1.18-1.22).
Patients with at least 5 comorbidities had a significantly higher likelihood of being screened for CRC when compared with patients who did not have comorbidities (ARR=1.12; 95% CI, 1.1-1.14). However, patients with at least 5 comorbidities had a lower likelihood of undergoing CRC screening when compared with patients who had 2 to 4 comorbidities.
“This indicates that physicians may be more burned out and less likely to recommend CRC screening to patients with many comorbidities compared with patients who have only been diagnosed with only a few conditions,” the study authors explained. “Aside from physician burnout, the decrease in CRC screening in patients with at least five comorbidities could also be attributed to not enough time being spent with the patient.”
Greiner B, Gandhi R, Abrol R, Patel M, Hartwell M. National disparities in colorectal cancer screening in patients with comorbid conditions: an analysis of the Behavioral Risk Factor Surveillance System. J Osteopath Med. Published online April 23, 2021. doi:10.1515/jom-2021-0066