Texans in rural areas less likely to receive colorectal cancer screening

Texans living in rural areas are less likely to have colorectal cancer screening, according to research conducted by the Texas A&M Health Science Center School of Public Health.

Colorectal cancer ranks second in cancer incidence and third in cancer-related deaths in the United States. Colon cancer usually originates as polyps, or abnormal cell growths, in the large intestine. Routine colorectal cancer screening is recommended beginning at 50 years old. For those with a family history of colon cancer, screening is recommend at a much earlier age.

Using the Centers for Disease Control and Prevention 2012 Behavioral Risk Factor Surveillance Survey, researchers analyzed the influence of certain factors on colorectal cancer screening among Texas residents 50 years or older who had fecal occult blood test (FOBT) or an endoscopy procedure, such as colonoscopy. The primary factor of interest was rural versus urban residence. Some additional factors considered were race, health insurance coverage and having a personal doctor.

In findings published recently in The Journal of Rural Health, researchers found that rural Texas residents were less likely to have ever had colorectal cancer screenings. Even among respondents who had been screened using FOBT, rural residents were less likely to be up-to-date with screening.

Chinedum Ojinnaka, M.B.B.S, M.P.H, lead author and doctoral student in Health Services Research at the Texas A&M School of Public Health, believes strategies to improve screening rates should ensure that underserved groups in rural areas not only have access to screening tests, but also are educated on the importance of adhering to the recommended screening guideline intervals.

Also, the prohibitive cost of a colonoscopy potentially restricts low-income or uninsured individuals to using only FOBT for colorectal cancer screening. Expanding options for screening tests by providing free or subsidized colonoscopies to these individuals should be explored as a means of reducing disparities among these groups.

“To our knowledge this is the first study to explore important predictors of colorectal cancer screening among residents of Texas living in rural areas,” Ojinnaka said. “If not addressed, rural residents and those who have inadequate access to health care could be at increased risk for colorectal cancer incidence and mortality as a result of suboptimal screening.”

Additional researchers from the Texas A&M School of Public Health included Yong Choi, M.P.H., Hye-Chung Kum, Ph.D. and Jane Bolin, Ph.D., J.D., B.S.N.