Table 2.
Rates of colorectal cancer screening in persons 70 years of age or older according to patient characteristics (N=27,068)
| Characteristic | Colorectal Cancer Screening 2-Year Cumulative Incidence* % (95% CI) |
Adjusted Colorectal Cancer Screening 2-Year Cumulative Incidence† % (95% CI) |
|---|---|---|
| Age, years | ||
| 70–74 | 49.9 (48.9–50.8) | 47.2 (46.9–47.4) |
| 75–79 | 46.7 (45.7–47.7) | 46.3 (45.8–46.8) |
| ≥ 80 | 37.6 (36.5–38.8) | 43.9 (43.4–44.3) |
| Gender | ||
| Men | 45.9 (45.3–46.5) | 45.7 (45.5–45.8) |
| Women | 38.6 (35.6–41.8) | 44.1 (43.5–44.8) |
| Race/Ethnicity | ||
| White | 46.8 (46.2–47.5) | 46.5 (46.3–46.6) |
| Black | 39.8 (37.9–41.8) | 39.6 (39.1–40.1) |
| White Hispanic | 27.2 (22.2–33) | 30.3 (29.1–31.6) |
| Other | 38.9 (34.9–43.1) | 42.5 (41.3–43.7) |
| Charlson Score | ||
| 0 (best health) | 46.7 (45.7–47.7) | 47.0 (46.8–47.3) |
| 1–3 (average health) | 46.0 (45.2–46.9) | 45.8 (45.6–46.0) |
| ≥ 4 (worst health) | 40.6 (38.9–42.3) | 40.7 (40.4–41.0) |
| Selected Charlson Comorbidities‡ | ||
| Congestive Heart Failure | 39.6 (38–41.2) | 41.2 (40.7–41.7) |
| Peripheral Vascular Disease | 45.7 (43.7–47.7) | 47.2 (46.7–47.7) |
| Cerebrovascular Disease | 42.8 (41.1–44.5) | 44.4 (44.0–44.8) |
| Dementia | 17.4 (14.6–20.7) | 19.2 (18.5–19.9) |
| COPD | 43.2 (41.9–44.5) | 43.8 (43.5–44.1) |
| Diabetes | 46.7 (45.5–47.9) | 47.2 (46.8–47.5) |
| Diabetes with Complications | 46.4 (44.1–48.9) | 48.6 (47.9–49.2) |
| Chronic Renal Failure | 36.4 (33.5– 39.4) | 39.4 (38.6– 40.3) |
| Metastatic Solid Tumor | 33.2 (28.5– 38.5) | 36.9 (35.9– 37.9) |
| Home Bound§ | ||
| No | 46.3 (45.7– 46.9) | 46.1 (46.0– 46.3) |
| Yes | 24.2 (21.5– 27.3) | 26.5 (25.7– 27.2) |
| Married | ||
| No | 38.9 (37.9– 39.9) | 40.2 (40– 40.5) |
| Yes | 49.8 (49.1–50.6) | 48.6 (48.5–48.7) |
| Lived in ZCTA in which ≥ 25% of Adults Had a College Education ¶ |
||
| No | 46.6 (45.9–47.4) | 46.3 (46.1–46.5) |
| Yes | 44.3 (43.3–45.3) | 44.4 (44.2–44.7) |
| Median Income of ZCTA ¶ | ||
| Highest Tertile (> $29,194) | 47.4 (46.4–48.5) | 46.5 (46.2–46.8) |
| Middle Tertile | 45.5 (44.5–46.5) | 45.5 (45.3–45.7) |
| Lowest Tertile (< $21,169) | 44.3 (43.3–45.4) | 44.5 (44.2–44.8) |
| VA Site | ||
| Minneapolis | 47.6 (46.7–48.5) | 46.4 (46.1–46.6) |
| Durham | 51.8 (50.5–53.1) | 52.0 (51.7–52.3) |
| Portland | 43.6 (42.1–45.1) | 43.5 (43.3–43.8) |
| West Los Angeles | 38.0 (36.8–39.2) | 40.6 (40.3–41.0) |
| Distance to Nearest VA Clinic |
||
| < 10 miles | 41.9 (41.1–42.7) | 44.5 (44.3–44.7) |
| 10–49 miles | 49.1 (48.3–50) | 46.7 (46.6–46.9) |
| ≥ 50 miles | 48.6 (46–51.4) | 47.1 (46.6–47.7) |
| Number of VA Outpatient Visits (Primary Care, GI, or Surgery), 2001–2002∥ |
||
| 0 | 23.7 (22.6–25.0) | 23.0 (22.7–23.3) |
| 1 | 45.5 (44.5–46.6) | 43.9 (43.7–44.1) |
| 3 | 52.5 (51.4–53.6) | 52.1 (51.8–52.3) |
| ≥ 4 | 55.1 (53.8–56.5) | 57.4 (57.1–57.6) |
| Type of VA Outpatient Visit, 2001–2002 |
||
| Seen in Primary Care, GI, or Surgery Clinic |
50.1 (50.0–50.3) | 50.1 (50.0–50.3) |
| Never attended Primary Care, GI, or Surgery Clinic |
23.7 (22.6–25.0) | 23.0 (22.7–23.3) |
Cumulative incidence at 2 years converted to percent, estimated from Kaplan-Meier analysis. Complete-case analyses were conducted because missing data were minimal. The following variables had missing data: Distance to nearest VA clinic (0.2%); Income (2.4%); Education (2.4%); Married (3.3%); Race/Ethnicity (1.0%).
Estimated 2-year cumulative incidence from Cox regression models adjusted for age, gender, race, marital status, VA site, education and income categories, Charlson comorbidity category as well as an interaction between age (continuous and centered) and VA site. Adjusted estimates for each site represent the incidence at the mean age of the cohort (77 years).
The comparison group is all patients without the comorbidity of interest.
Enrolled in VA Home Based Primary Care at the start of 2001.
ZCTA = Zip Code Tabulation Area
Defined by VA clinic codes 301, 303, 305, 306, 307, 309, 312, 321–323, and 401 representing primary care clinics subjected to the 2001–2002 VA colorectal cancer screening performance measure (e.g., General Medicine, Cardiology, Endocrinology, Diabetes, Hypertension, Pulmonary, Women’s Clinic) as well as Gastroenterology and General Surgery.