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

Meng-Han Tsai; Caitlyn Grunert; Jacqueline B Vo; Justin X Moore; Avirup Guha

doi:10.3390/cancers15072077

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

Cancers (Basel). 2023 Mar 30;15(7):2077. doi: 10.3390/cancers15072077.

Authors

Meng-Han Tsai^{1

2}, Caitlyn Grunert¹, Jacqueline B Vo³, Justin X Moore^{1

4}, Avirup Guha⁵

Affiliations

¹ Cancer Prevention, Control & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
² Georgia Prevention Institute, Augusta University, Augusta, GA 30912, USA.
³ Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD 20814, USA.
⁴ Institute of Public and Preventive Health, Augusta University, Augusta, GA 30912, USA.
⁵ Cardio-Oncology Program, Georgia Cancer Center, Division of Cardiology, Department of Medicine, Cardiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.

Abstract

Purpose: Our study aimed to examine the association between the presence of chronic diseases with guideline-concordant colorectal cancer (CRC) screening utilization among breast cancer survivors.

Methods: We analyzed data among women with a history of breast cancer from the 2016, 2018, and 2020 Behavioral Risk Factor Surveillance System. Receipt of guideline-concordant CRC screening was the outcome of interest. Diabetes, coronary heart disease/myocardial infarction, stroke, chronic obstructive pulmonary disease, emphysema/chronic bronchitis, arthritis, depressive disorder, or kidney diseases were included in chronic disease conditions.

Results: Among 1324 survivors, those with multi-morbidities (3+ chronic diseases; 88.3%) had higher CRC screening use compared to those with one (84.4%) or two (85.4%) diseases (p-value < 0.05). In multivariable analysis, survivors with multi-morbidities were two times more likely to have CRC screening compared to those with only one disease (OR, 2.10; 95% CI, 1.11-3.98). Among survivors with multi-morbidities, Black women (OR, 14.07; 95% CI, 5.61-35.27), and those with frequent poor physical health (OR, 3.32; 95% CI, 1.57-7.00) were positively associated with CRC screening use. Conversely, survivors with frequent poor mental health were 67% less likely to receive CRC screening (OR, 0.33; 95% CI, 0.14-0.74).

Conclusion: Among breast cancer survivors, multi-morbidities were positively associated with CRC screening.

Keywords: breast cancer survivors; chronic disease conditions; colorectal cancer screening; quality of life.

Grants and funding

This research was supported at least in part through the Georgia Cancer Center Paceline funding mechanism (principal investigator: Meng-Han Tsai, MCGFD01050). Justin X. Moore was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number K01MD015304. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Moreover, Avirup Guha is supported by American Heart Association-Strategically Focused Research Network Grant in Disparities in Cardio-Oncology (#847740, #863620).