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Spatial patterns of colorectal cancer screening facilities, screening adherence, and colorectal cancer mortality
Purpose: To assess spatial patterns of CRCS facility locations, facility-level CRCS adherence among adults 50+ years, and county-level CRC mortality rates in Minnesota.
Methods: The name, address, and CRCS adherence for all Minnesota facilities that perform CRCS (N=622) were obtained from the 2013 Minnesota Community Measurement, which requires all facilities to report given a state mandate. Minnesota county-level age-adjusted CRC mortality rates were calculated using 2007-2011 mortality data from the Minnesota Department of Health (N=61 of 87 counties with sufficient data). Geographic Information Systems was used to geocode facility address, and map facility CRCS adherence and county-level CRC mortality rates.
Results: The average Minnesota age-adjusted mortality rate was 14.6/100,000. Four of nine counties with the highest mortality rates (i.e., >18.4/100,000) had all facilities reporting <69% CRCS adherence. Conversely, 7% of counties with higher than average mortality rates had all county facilities reporting >70% CRCS adherence (range: 71-83%). Within each county in the Twin Cities metropolitan area, large disparities existed in facility-level CRCS adherence. For example, four of the 10 top-performing Minnesota facilities (CRCS adherence: 87-99%) were located in Hennepin County (county mortality: 14.1/100,000); however, ~50% of 116 Hennepin County facilities reported CRCS adherence <69% (range: 2-68%). Clustering of low- and high-performing facilities existed within some metropolitan counties.
Conclusions: While county-level mortality rates may be similar to the state average, disparities in facility-level CRCS adherence within a county indicate CRCS variations across small areas, which deserves further study so CRCS efforts can be appropriately and effectively targeted.
Learning Areas:
EpidemiologyProvision of health care to the public
Public health or related research
Learning Objectives:
Describe the spatial pattern of facilities providing colorectal cancer screening in Minnesota.
Explain the facility-level colorectal cancer screening adherence patterns in Minnesota.
Identify Minnesota counties with the highest and lowest age-adjusted colorectal cancer mortality rates.
Keyword(s): Cancer Prevention and Screening, Geographic Information Systems (GIS)
Qualified on the content I am responsible for because: I am a third-year PhD student and my research is focused on reducing geographic disparities in colorectal cancer screening. I have been actively involved in a community-based colorectal cancer screening intervention study, which uses shared decision making methods to increase colorectal cancer screening.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.