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

Kiara N. Mayhand, Elizabeth A. Handorf, Angel G. Ortiz, Evelyn T. Gonzalez, Amie Devlin, Kristen A. Sorice, Nestor Esnaola, Susan Fisher and Shannon M. Lynch
Additional contact information
Kiara N. Mayhand: Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, 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
Shannon M. Lynch: Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA

IJERPH, 2021, vol. 18, issue 9, 1-17

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.

Keywords: colorectal cancer; screening adherence; socioeconomic status; neighborhood factors; disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/9/4398/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/9/4398/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:9:p:4398-:d:540251

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().