Body mass index and colorectal cancer screening among cancer survivors: the role of sociodemographic characteristics.

Abstract

We examined the association between body mass index (BMI) and guideline-concordant colorectal cancer (CRC) screening utilization among cancer survivors while considering the role of sociodemographic characteristics using a representative sample of the United States. We conducted a cross-sectional analysis utilizing data from the 2022 and 2020 Behavioral Risk Factor Surveillance System. Our outcome of interest was guideline-concordant CRC screening utilization and our exposure of interest was BMI. We performed weighted descriptive statistics and multivariable logistic regression analysis to examine the mentioned associations. Among 44,244 eligible cancer survivors, those who were overweight (84%) had the greatest CRC screening use, followed by those who were obese (81.3%), and underweight/normal weight (79.2%; p values < 0.001). Multivariable logistic regression analysis revealed those who were overweight or obese compared to underweight/normal weight had 1.2-1.3-fold increased odds of having guideline-concordant CRC screening (overweight: OR: 1.27; 95% CI: 1.09-1.49; obese: OR: 1.18; 95% CI: 1.00-1.39). Our subpopulation analyses within the levels of BMI showed that females who were overweight (OR: 0.83; 95% CI: 0.69-1.00) and non-Hispanic other (NHO) survivors who were underweight/normal weight (OR: 0.47; 95% CI: 0.24-0.91) were 17%-53% less likely to be screened for CRC. Our findings indicate that BMI was positively associated with guideline-concordant CRC screening use among cancer survivors. However, female survivors who were obese and NHO survivors who were underweight/normal weight were less likely to be screened for CRC. Cancer survivorship care that integrates weight management and specific sociodemographic characteristics has potential for improving CRC screening adherence.