The role of obesity-risk perception and gender differences in colorectal cancer screening among eligible adults in the United States

Early detection of colorectal cancer (CRC) is crucial in reducing the associated morbidity and mortality. Our study aims to assess the association between obesity-cancer risk perception and the uptake of CRC screening among eligible adults in the United States. Additionally, we explored the variation of association stratified by gender. We analyzed data from the Health Information National Trends Survey (HINTS) 2018–2020. We performed descriptive statistics, bivariable, and multivariable logistic regression analysis. Of the 6435 overweight and obese US adults ≥ 45 years, 69 % (n = 4970) performed CRC screening. Approximately 85.4 % (n = 3243) of participants who believed that obesity increased the risk of cancer were screened. Perceived risk of obesity-related cancer was associated with 35 % significantly higher odds of screening (cOR:1.35,95 %CI:1.03–1.75). When compared to participants with no insurance, participants with health insurance had significantly higher odds of undergoing CRC screening (aOR:4.41,95 %CI:1.87–10.40). Non-Hispanic Black individuals had significantly higher odds of CRC screening compared to non-Hispanic White individuals (aOR: 2.17, 95 % CI: 1.04–4.51). For every one-year increase in age, there is an 11 % increase in screening (aOR:1.11,95 %Cl:1.07–1.16). There was no significant difference in CRC screening rates between males and females. Non-Hispanic Black females had significantly higher adjusted odds of CRC screening (aOR:3.17, 95 %CI:1.23–8.19) compared to non-Hispanic White females. Female college graduates had significantly higher odds of screening when compared to high school graduates (aOR:2.86,95 %CI:1.07–7.61). When compared to males who are non-smokers, former smokers had significantly higher odds of undergoing CRC screening (aOR:2.97,95 %CI:1.19–7.45). Male homosexuals/gay/lesbian when compared to heterosexual/straight males had significantly higher odds to be screened for CRC (aOR: 10.17,95 % CI:1.13–91.10). This study provided essential insights that help bridge gaps in cancer disparities, revealing that race/ethnicity and insurance status significantly impact CRC screening uptake. Health promotion programs should implement tailored interventions that emphasize perceived susceptibility to obesity and consider gender-specific factors to increase CRC screening rates.