Disparities in colorectal cancer screening adherence in Ohio: Associations with demographic, socioeconomic and geographic factors

Background: Previously identified sociodemographic factors associated with colorectal cancer (CRC) screening have not consistently been evaluated simultaneously and in the context of additional regional geographic factors, such as urban/rural and Appalachian residence. This study aims to evaluate these factors and adherence to 2021 U.S. Preventive Services Task Force (USPSTF) CRC screening guidelines among Ohio residents.Methods: Participants were recruited into wave 2 (conducted in 2023-2024) of the Community Initiative Towards Improving Equity and Health Status (CITIES) Study and surveyed to assess sociodemographic factors and CRC screening adherence. Multivariable logistic regression analyses were used to identify independently associated factors.Results: CRC screening adherence was independently associated with age (65 + years vs. 45–54 years, OR: 6.36, 95% CI: 3.58-11.30), income ($100,000 + vs. <$49,999, OR: 2.18, 95% CI: 1.27-3.76), health insurance coverage (yes vs. no, OR: 5.15, 95% CI: 1.77-14.92), and residence in an Appalachian (yes vs. no, OR:1.90, 95% CI: 1.13-3.20) or an urban (vs. rural) county (OR: 1.80, 95% CI: 1.11-2.92).Discussion: CRC screening adherence in Ohio is shaped by intersecting sociodemographic and geographic factors. These findings support expanding culturally tailored interventions and targeting rural and younger residents, and those with lower income to enhance CRC screening adherence.