# Revealing New Patterns in Colorectal Cancer Screening with a Focus on a Younger Patient Population

## TL;DR

This study finds that younger patients and certain demographic groups are less likely to complete colorectal cancer screening, suggesting a need for targeted interventions.

## Contribution

The study identifies both traditional and nontraditional factors affecting CRC screening completion in younger and general populations.

## Key findings

- Younger patients had significantly lower CRC screening completion rates compared to older patients.
- Non-employed, single, and tobacco-using individuals were less likely to be up to date with CRC screening.
- Noninvasive screening modalities were more commonly chosen by younger patients.

## Abstract

With the growing disease burden of colorectal cancer (CRC) screening in both the general and younger patient populations, it is important to identify disparities in screening that may be amenable to targeted intervention. In our study, we analyzed both traditional elements known to contribute to overall health-related disparities (e.g., race, occupation) as well as nontraditional elements (e.g., relationship status, smoking status, body mass index), all of which we demonstrated to have some effect on successful CRC screening completion in both general and age-stratified patient populations.

Colorectal cancer (CRC) continues to impart a significant mortality burden in the United States, with a growing number of cases affecting younger individuals. In this study, we set out to characterize predictors of missed colorectal cancer screening in a general and age-stratified population. Methods: We analyzed a patient population of over 85,000 patients who presented to a large outpatient network in the Baltimore, Maryland area and were due for CRC screening. We analyzed different characteristics, including race, occupation, relationship status, tobacco smoking status, and body mass index, of patients up to date and overdue on their CRC screening. The majority (over 99%) of our patient population was insured. We performed this analysis on the patient population as a whole and as an age-stratified patient population. Results: In our overall patient population, all of the aforementioned characteristics were significantly different between patients up to date and those overdue on CRC screening. Races with the highest up-to-date CRC screening proportion were Pacific Islanders, East Asian, and White patients, while Asian Indian patients had the lowest up-to-date percentage. Non-employed patients (including patients with disabilities and students), single patients, and current or past tobacco smokers were all found to have significantly lower percentages of up-to-date patients as compared to other groups within these categories. BMI was significantly lower in up-to-date patients. In our age-stratified analysis, younger patients had a significantly lower percentage of up-to-date patients. Notably, younger patients had a significantly higher proportion of patients electing for noninvasive screening modalities. Conclusions: These disparities in CRC screening warrant targeted interventions to minimize future risk of heightened mortality in certain patient populations.