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Colorectal cancer screening at US community health centers: Examination of sociodemographic disparities and association with patient‐provider communication
Author(s) -
Lin Sue C.,
McKinley Duane,
Sripipatana Alek,
Makaroff Laura
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30855
Subject(s) - medicine , odds ratio , confidence interval , family medicine , odds , cancer screening , logistic regression , receipt , demography , ethnic group , health care , behavioral risk factor surveillance system , community health , cancer , public health , nursing , sociology , world wide web , computer science , anthropology , economics , economic growth
BACKGROUND Colorectal cancer (CRC) screening rates are low among underserved populations. High‐quality patient‐physician communication potentially influences patients' willingness to undergo CRC screening. Community health centers (HCs) provide comprehensive primary health care to underserved populations. This study's objectives were to ascertain national CRC screening rates and to explore the relations between sociodemographic characteristics and patient‐provider communication on the receipt of CRC screening among HC patients. METHODS Using 2014 Health Center Patient Survey data, bivariate and multivariate analyses examined the association of sociodemographic variables (sex, race/ethnicity, age, geography, preferred language, household income, insurance, and employment status) and patient‐provider communication with the receipt of CRC screening. RESULTS Patients between the ages of 65 and 75 years (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.33‐4.64) and patients not in the labor force (aOR, 2.32; 95% CI, 1.37‐3.94) had higher odds of receiving CRC screening, whereas patients who were uninsured (aOR, 0.33; 95% CI, 0.18‐0.61) and patients who were non–English‐speaking (aOR, 0.42; 95% CI, 0.18‐0.99) had lower odds. Patient‐provider communication was not associated with the receipt of CRC screening. CONCLUSIONS The CRC screening rate for HC patients was 57.9%, whereas the rate was 65.1% according to the 2012 Behavioral Risk Factor Surveillance System and 58.2% according to the 2013 National Health Interview Survey. The high ratings of patient‐provider communication, regardless of the screening status, suggest strides toward a patient‐centered medical home practice transformation that will assist in a positive patient experience. Addressing the lack of insurance, making culturally and linguistically appropriate patient education materials available, and training clinicians and care teams in cultural competency are critical for increasing future CRC screening rates. Cancer 2017;123:4185–4192. © 2017 American Cancer Society .