ABSTRACT
Introduction: Federally Qualified Health Centers (FQHCs) provide preventive health services such as colorectal cancer (CRC) screening to low-income and underinsured individuals. Federally Qualified Health Center (FQHC) characteristics (2020 data) and the colorectal cancer (CRC) screening rate change (SRC) in California FQHCs from 2019 to 2020 by quartiles Frequency or Percent Overall (n=168) SRC Q1 (n=42) SRC Q2+Q3+Q4 (n=126) P Value Total Patients Eligible for CRC Screening (Age 50-74)Y 1,207,401 346,591 860,810 -- CRC Screening Rate in 2019 (median %) 44.5 53.7 41.6 < 0.0001 CRC Screening Rate in 2020 (median %) 36.8 31.2 37.7 0.030 Change in CRC Screening Uptake between 2020 and 2019 Median -5.7 -18.6 -3.1 < 0.0001 Interquartile Range -13.1,-0.6 -28.4,-15.1 -7.5,1.0 Sex Male (median %) 42.5 41.3 42.9 0.010 Race & Ethnicity (median %) White Non-Hispanic 17.5 11.5 18.9 0.002 Black Non-Hispanic 3.0 2.8 3.0 0.890 Hispanic/Latina/Latino/Latinx 55.8 68.2 51.1 0.002 Other Non-Hispanic 3.2 2.9 3.4 0.180 Preference for Non-English Language (median %) 33.1 38.7 30.6 0.009 Urban FQHCs, n (%) 133 (79.2%) 38 (90.5%) 95 (75.4%) 0.040 Experiencing Homelessness (median %) 3.2 3.3 3.2 0.890 Income Level >200% Federal Poverty Line (median %) 3.3 2.7 3.8 0.480 Uninsured (median %) 18.6 18.8 18.5 0.120 Medicaid (median %) 39.3 35.9 40.3 0.240 Medicare/Medicaid Dually Eligible (median %) 4.2 3.0 4.7 0.002 Private Insurance (median %) 8.6 10.2 8.3 0.610 Agricultural Workers (median %) 0.9 1.0 0.7 0.790 *SRC Q1 represents FQHCs with the largest decline in CRC screening rates from 2019 to 2020, and SRC Q2+Q3+Q4 represents all other FQHCs. *p-values represent comparisons (Wilcoxon rank-sum and chi-square tests) between the first quartile and second through fourth quartiles combined for FQHCs’ median percentage of White, Black, Hispanic/Latino, and other races, median percentage patient population with preference for non-English language, homelessness, income level above 200% of the Federal Poverty Line, uninsured status, and FQHC urbanicity. YThese calculated values do not account for practice-changing 2021 United States Preventative Services Task Force guideline updates dictating that average-risk patients begin CRC screening at age 45.