142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

312212
Spatial patterns of colorectal cancer screening facilities, screening adherence, and colorectal cancer mortality

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 9:10 AM - 9:30 AM

Qin Shen, MS , Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA
Resa M. Jones, MPH, PhD , Division of Epidemiology, Department of Family Medicine and Population Health & Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
Background:  Geographically mapping facilities offering colorectal cancer screening (CRCS), facility-level CRCS adherence, and county-level colorectal cancer (CRC) mortality rates could help identify CRCS disparities to better target screening promotion and resources.

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:

Epidemiology
Provision 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)

Presenting author's disclosure statement:

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.