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Effect of Neighborhood and Individual-Level Socioeconomic Factors on Colorectal Cancer Screening Adherence

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Listed:
  • Kiara N. Mayhand

    (Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
    Department of Public Health, The College of New Jersey, Ewing, NJ 08618, USA)

  • Elizabeth A. Handorf

    (Fox Chase Cancer Center, Population Studies and Biostatistics Facility, Philadelphia, PA 19111, USA)

  • Angel G. Ortiz

    (Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA)

  • Evelyn T. Gonzalez

    (Office of Community Outreach & Engagement, Fox Chase Cancer Center, Philadelphia, PA 19111, USA)

  • Amie Devlin

    (Department of Clinical Sciences, Temple University, Philadelphia, PA 19140, USA)

  • Kristen A. Sorice

    (Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA)

  • Nestor Esnaola

    (Department of Surgery Houston Methodist Hospital Houston Methodist Weill Cornell Medical College, Houston, TX 77030, USA)

  • Susan Fisher

    (Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
    Department of Clinical Sciences, Temple University, Philadelphia, PA 19140, USA)

  • Shannon M. Lynch

    (Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA)

Abstract

Despite the effectiveness of screenings in reducing colorectal cancer (CRC) mortality, ~25% of US adults do not adhere to screening guidelines. Prior studies associate socioeconomic status (SES) with low screening adherence and suggest that neighborhood deprivation can influence CRC outcomes. We comprehensively investigated the effect of neighborhood SES circumstances (nSES), individual SES, and race/ethnicity on adherence to CRC screening in a multiethnic cross-sectional study. Participant surveys assessing 32 individual-level socioeconomic and healthcare access measures were administered from 2017 to 2018. Participant data were joined with nine nSES measures from the US Census at the census tract level. Univariate, LASSO, and multivariable mixed-effect logistic regression models were used for variable reduction and evaluation of associations. The total study population included 526 participants aged 50–85; 29% of participants were non-adherent. In the final multivariable model, age ( p = 0.02) and Non-Hispanic Black race ( p = 0.02) were associated with higher odds of adherence. Factors associated with lower adherence were home rental (vs. ownership) ( p = 0.003), perception of low healthcare quality ( p = 0.006), no routine checkup within two years ( p = 0.002), perceived discrimination ( p = 0.02), and nSES deprivation ( p = 0.02). After comprehensive variable methods were applied, socioeconomic indicators at the neighborhood and individual level were found to contribute to low CRC screening adherence.

Suggested Citation

  • Kiara N. Mayhand & Elizabeth A. Handorf & Angel G. Ortiz & Evelyn T. Gonzalez & Amie Devlin & Kristen A. Sorice & Nestor Esnaola & Susan Fisher & Shannon M. Lynch, 2021. "Effect of Neighborhood and Individual-Level Socioeconomic Factors on Colorectal Cancer Screening Adherence," IJERPH, MDPI, vol. 18(9), pages 1-17, April.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:9:p:4398-:d:540251
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    References listed on IDEAS

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