Racial/Ethnic Disparity in the Relationship of Mental and Physical Health With Colorectal Cancer Screening Utilization Among Breast and Prostate Cancer Survivors

Abstract

PURPOSE: We examined colorectal cancer (CRC) screening utilization among non-Hispanic White, non-Hispanic Black (NHB), non-Hispanic other (NHO)/Hispanic cancer survivors. We also determined whether experiencing poor physical and/or mental health affects CRC screening utilization in breast and prostate cancers across different racial/ethnic groups. METHODS: Data from years 2016, 2018, and 2020 of the Behavioral Risk Factor Surveillance System on 3,023 eligible treatment-utilizing cancer survivors with complete treatment were used. We performed descriptive statistics and multivariable logistic regression to examine the mentioned association. RESULTS: Among 3,023 eligible survivors, 67.7% of NHO/Hispanic survivors demonstrated lower CRC screening use compared with non-Hispanic White (82%) and NHB (89%) survivors ( P < .001). In multivariable analysis, having frequent (14-30 days) poor mental health was associated with lower odds of receiving CRC screening among NHB (odds ratio [OR], 0.32; 95% CI, 0.11 to 0.95) and NHO/Hispanic (OR, 0.39; 95% CI, 0.18 to 0.81) survivors. Similar results in physical health were also found in NHB (OR, 0.34; 95% CI, 0.13 to 0.91) and NHO/Hispanic (OR, 0.22; 95% CI, 0.05 to 0.91) groups. Among those experienced both frequent poor mental and physical health, NHB/NHO/Hispanic were less likely to be screened for CRC (OR, 0.05; 95% CI, 0.02 to 0.10). CONCLUSION: NHO/Hispanic survivors demonstrated lower CRC screening use. Frequent poor mental and/or physical health was strongly associated with lower CRC screening use among NHB and NHO/Hispanic survivors. Our study suggests that cancer survivorship care considering mental and physical health status may improve adherence to CRC screening recommendation (for secondary cancer prevention) for NHB, NHO, and Hispanic survivors.

Caregiving responsibility and psychological distress among community-dwelling cancer survivors in the United States

“…Finally, our results showed that cancer survivors who perceived themselves to have fair or poor health or had an additional CC were more likely to experience mild and moderate to severe psychological distress. Prior studies have shown that poorly perceived health and comorbid medical conditions are correlated with experiencing symptoms of psychological distress [20,56,57]…”

“…Vulnerable populations, particularly rural populations, sexual and gender minorities, and minoritized racial and ethnic populations, often face greater challenges navigating cancer survivorship [16,17]. Racial and ethnic minority groups may also experience disparities in cancer survivorship, including differential access to early treatment and quality care, leading to inequalities in physical and mental health outcomes [18][19][20].…”

“…In support of these claims [56]. Further, Tsai et al (2023) report that cancer survivors with one to two CCs were more likely to report several days of poor mental health, while survivors with ≥ 3 CCs were more likely to experience both frequent poor mental and physical health[20]. Thus, having a larger number of CCs beyond cancer compounds the emotional toll on cancer survivors.…”

Presence of Multi-Morbidities and Colorectal Cancer Screening Utilization among Breast Cancer Survivors

“…A prior study observed that Hispanic survivors were less likely to be screened for CRC [ 13 ]. Factors associated with low screening use include worse quality of life and low income among Hispanic survivors [ 15 ]. Conversely, greater CRC screening use was found when survivors received a survivorship care plan in breast, cervical, colorectal, prostate, melanoma, and other cancers [ 13 ].…”