Your browser doesn't support javascript.
DECLINE IN COLORECTAL CANCER SCREENING RATES IN FEDERALLY QUALIFIED HEALTH CENTERS IN THE UNITED STATES BETWEEN 2019 AND 2020
Gastroenterology ; 162(7):S-109-S-110, 2022.
Article in English | EMBASE | ID: covidwho-1967241
ABSTRACT
Introduction Screening for colorectal cancer (CRC) varies significantly by sociodemographic factors. The Health Resources and Services Administration (HRSA) provides primary care services, including CRC screening, to over 30 million medically underserved individuals at Federally Qualified Health Centers (FQHCs) in the United States (US). Given known disparities in CRC screening utilization and the national decline in screening due to the COVID- 19 pandemic, we aimed to determine the change in screening rates in FQHCs between 2019 and 2020 and factors associated with changes in rates. Methods This repeated cross-sectional analysis was conducted using 2019 and 2020 data from the Uniform Data System (UDS), which includes FQHC quality data for all US FQHCs. We ed CRC screening rates for each FQHC and for each state (FQHCs only) for patients age 50-75 for the years 2019 and 2020. We then calculated the change in screening (2020 rate minus 2019 rate) for each FQHC and for each state. To compare FQHC characteristics, we separated FQHCs into quartiles based on the 2020 screening rate and used ANOVA to compare FQHC characteristics between quartiles. Lastly, we performed a multivariable logistic regression to determine FQHC-level characteristics (2020 data) associated with an increase vs. decrease in screening rate from 2019 to 2020. Results In the 50 states, there were 1308 FQHCs and 7,132,411 FQHC patients eligible for CRC screening in 2020. Change in screening rates by state ranged from -11.1% (North Carolina) to +6.71% (Alaska) (mean= -3.55%) (Figure). The mean change in screening rates in FQHCs was -3.6% (range -62% to +58%) (Table). FQHCs with the lowest screening rates in 2020 (quartile 1, Table) had higher percentages of Black (p<0.001), male (p=0.018), homeless (p<0.001), uninsured (p<0.001), and low-income (p<0.001) patients, and were more likely to be in urban settings (p<0.001). FQHCs with the highest screening rates (quartile 4, Table) had a higher percentage of White (p<0.001) patients. When controlling for FQHC characteristics (including number of patients and 2019 CRC screening rate), each one point increase in the percentage of White patients served in a FQHC was associated with lower odds (aOR 0.71;95%CI=0.56-0.91) of experiencing a decrease in CRC screening rates in 2020 compared to 2019 (data not shown). Discussion FQHCs in the US have below-average CRC screening rates and saw notable declines in CRC screening utilization during the COVID-19 pandemic. Extent of decline varied broadly by state and FQHC, and declines were greater in FQHCs that served a higher proportion of (Figure Presented) Figure. Percent change in colorectal cancer (CRC) screening rate among adults age 50 to 74 at Health Resources and Services Administration-funded FQHCs between 2019 and 2020, by US state. (Table Presented) Table. FQHC characteristics (2020 data) and CRC screening rates (2019 and 2020) for HRSA-funded FQHCs in the US overall and by 2020 CRC screening rate quartiles.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Gastroenterology Year: 2022 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Gastroenterology Year: 2022 Document Type: Article