Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Hui Xie , Yannan Li , Haoxin Le , Qian Wang , Nicholas Theodoropoulos , Chi Wen
Background: We have limited information on CRC screening disparities in people of color (POC) with sexual minority identity. Methods: We analyzed the Behavioral Risk Factor Surveillance Survey (BRFSS) data of males assigned at birth age 50-75 years for up-to-date CRC screening. Descriptive analyses in demographics, socioeconomics, healthy behaviors, and CRC screening were conducted by race/ethnicity, followed by multivariable regressions to identify predictors of CRC screening stratified by race/ethnicity. Results: About 67.70% of eligible males reported having an up-to-date CRC screening that met the USPSTF guideline, with the highest rate among gay men (74.92%) and the lowest among bisexual men (65.35%; p = 0.0024). Non-Hispanic Whites had the higher rates of receiving CRC screening across all groups (p < 0.010). In the adjusted multivariable logistic models for NH-White males, gay men (1.52, 95% CI: 1.20-1.91), non-current smokers (1.56, 95% CI: 1.44-1.69), being overweight/obese (1.15, 95%CI: 1.07-1.23), and being physically active (1.08, 95%CI: 1.00-1.16) had greater odds of having CRC screening. Similar patterns were not found in Hispanic and non-Hispanic Black males. Gay men (3.88, 95% CI: 1.51-9.98) had greater odds of CRC screening in Hispanics, whereas being a non-current smoker (1.42, 95%CI: 1.13-1.79) was a significant factor in NH-Blacks. Health insurance coverage was a significant factor across all racial/ethnic groups. Conclusions: CRC screening disparities were most pronounced among racial/ethnic minority males. Future work on developing tailored CRC screening programs for racial/ethnic subgroups using an intersectional framework is warranted to elucidate observed heterogeneity across race/ethnicity and sexual orientation.
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