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Background <p>Although lifestyle modifications have the potential to reduce colorectal cancer (CRC) risk, regular screening is crucial for CRC prevention. This study aimed to identify disparities in CRC screening modalities in Rhode Island (RI) adults from 2011 to 2021 to guide equitable screening practices.</p> Methods <p>We leveraged deidentified health insurance claims data from HealthFacts RI, the state’s all-payer claims database. Multivariable GEE regression models were used to assess the odds of CRC screening type (<i>i.e.</i>, CT colonography, colonoscopy, FOBT, mt-sDNA, or flexible sigmoidoscopy) and colonoscopy procedure (with or without polypectomy and/or biopsy) associated with each independent variable (<i>i.e.</i>, sex, insurance status, age, type of screening provider, and community-level economic burden).</p> Results <p>The analytic sample included 652,280 screenings from 2011 to 2021, of which 50.21% were attributable to females and 49.78% to males. Colonoscopies accounted for 49.93% of screenings, followed by FOBT at 45.34%. Females had over twice the odds of receiving CT colonography (OR = 2.47) but approximately 25% lower odds of receiving FOBT (OR = 0.73) compared to males. Those in economically disadvantaged communities had higher odds of receiving CT colonography (OR = 1.37), but lower odds of mt-sDNA screenings (OR = 0.71). Screenings ordered by unclassified providers had three times the odds of being FOBT (OR = 3.08) compared to other providers. These findings were all statistically significant at the 0.05 alpha level.</p> Discussion <p>We found discrepancies in CRC screening modalities by sex, age, insurance status, type of provider, and community-level economic burden, highlighting the need for targeted interventions to promote equitable CRC screening in Rhode Island.</p>

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Evaluation of colorectal cancer screening practices in Rhode Island, 2011–2021

  • 期刊论文

  • 发表日期：

    2026年2月10日

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  • Yaideliz M. Romero-Ramos,
  • William Goedel,
  • Matthew Boudreau,
  • Shilo McBurney

摘要

Background

Although lifestyle modifications have the potential to reduce colorectal cancer (CRC) risk, regular screening is crucial for CRC prevention. This study aimed to identify disparities in CRC screening modalities in Rhode Island (RI) adults from 2011 to 2021 to guide equitable screening practices.

Methods

We leveraged deidentified health insurance claims data from HealthFacts RI, the state’s all-payer claims database. Multivariable GEE regression models were used to assess the odds of CRC screening type (i.e., CT colonography, colonoscopy, FOBT, mt-sDNA, or flexible sigmoidoscopy) and colonoscopy procedure (with or without polypectomy and/or biopsy) associated with each independent variable (i.e., sex, insurance status, age, type of screening provider, and community-level economic burden).

Results

The analytic sample included 652,280 screenings from 2011 to 2021, of which 50.21% were attributable to females and 49.78% to males. Colonoscopies accounted for 49.93% of screenings, followed by FOBT at 45.34%. Females had over twice the odds of receiving CT colonography (OR = 2.47) but approximately 25% lower odds of receiving FOBT (OR = 0.73) compared to males. Those in economically disadvantaged communities had higher odds of receiving CT colonography (OR = 1.37), but lower odds of mt-sDNA screenings (OR = 0.71). Screenings ordered by unclassified providers had three times the odds of being FOBT (OR = 3.08) compared to other providers. These findings were all statistically significant at the 0.05 alpha level.

Discussion

We found discrepancies in CRC screening modalities by sex, age, insurance status, type of provider, and community-level economic burden, highlighting the need for targeted interventions to promote equitable CRC screening in Rhode Island.