Abstract 2313 Use of Big Data to Assess Disparities in Adherence to Colorectal Cancer Surveillance: a Biological, Environmental, and Social Determinants of Health Integrated Approach

Objective: Colorectal cancer, a condition caused by biological and environmental factors, is the second most common cause of death in the United States. Early detection through surveillance and treatment are key to the reduction of colorectal cancer deaths but data shows that there are disparities in cancer surveillance among certain groups. This study aims to use the Behavioral Risk Factor Surveillance System (BRFSS) public dataset of over 400,000 individuals in the US to identify biological and environmental factors associated with adherence to the 2020 United States Preventive Services Task Force (USPSTF) colorectal cancer surveillance guidelines. Methods: The 2020 BRFSS is a public dataset of annual telephone surveys of adult U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services from all 50 states, the District of Columbia, and three U.S. territories. Adherence to USPSTF guidelines (outcome measure) was defined as annual stool FIT testing or colonoscopy every 10 years starting at age 50. Predictor variables evaluated for association with the outcome were biological (age, sex, race, and body mass index), behavioral (alcohol consumption, cigarette smoking), and environmental and social determinants of health (education, income, employment status, marital status, urban/rural residency status, access to physician and health coverage). Descriptive, univariate, and multivariate analyses were conducted in Stata. Results: The following factors were found to be statistically significantly (p < 0.05) associated with lower adherence to the colorectal surveillance guidelines: non-black races (compared to white race), males, those not living in the western region of the US, those without college graduation, those with below-average income, the employed, those who have smoked at least once, those without a healthcare provider or without medical coverage. Conclusion: Our study revealed that interventions targeting certain social determinants of health and disadvantaged populations are critical to ensuring equal access to surveillance for colorectal cancer and reducing colorectal cancer deaths in the US.