Associations Between Colorectal Cancer Screening and Glycemic Control in People With Diabetes | Boston, Massachusetts, 2005-2010 |Preventing Chronic Disease: July 2011: 10_0196

ORIGINAL RESEARCH
Associations Between Colorectal Cancer Screening and Glycemic Control in People With Diabetes, Boston, Massachusetts, 2005-2010
Joanne E. Wilkinson, MD, MSc; Larry Culpepper, MD, MPH

Suggested citation for this article: Wilkinson JE, Culpepper L. Associations between colorectal cancer screening and glycemic control in people with diabetes, Boston, Massachusetts, 2005-2010. Prev Chronic Dis 2011;8(4):A82.

http://www.cdc.gov/pcd/issues/2011/jul/10_0196.htm. Accessed [date].


PEER REVIEWED

Abstract
Introduction
Recent studies indicate an increased risk of colorectal cancer in people with diabetes. However, people with diabetes may have lower colorectal cancer screening rates than people without diabetes. Few data are available regarding factors associated with lack of screening for people with diabetes. Our objective was to describe factors associated with lack of timely colorectal cancer screening in people with diabetes.

Methods
We examined an electronic medical record database with more than 6,000 patients aged 50 years or older who had diabetes and were seen in a large hospital system in Boston, Massachusetts. We compared patients who had received timely colorectal cancer screening with those who had not on several variables, including glycemic control, expressed as average hemoglobin A1c (HbA1c). Bivariate analyses were performed using χ2 and t tests for means when applicable. Logistic regression was used to determine the independent association of variables with lack of screening.

Results
Patients with poor glycemic control (average HbA1c >8.5%) were more likely not to have been screened for colorectal cancer than those with good glycemic control, even after adjusting for the number of primary care visits. Patients with fewer than 20 primary care visits in 5 years were more likely not to have been screened than those with more visits.

Conclusion
Glycemic control appears to be independently associated with the likelihood of colorectal cancer screening. People with poorly controlled diabetes should be targeted in future research and individual patient care.

full-text:
Preventing Chronic Disease: July 2011: 10_0196

Author Information
Corresponding Author: Joanne E. Wilkinson, MD, MSc, Department of Family Medicine, Dowling 5, Boston University School of Medicine, 840 Harrison Ave, Boston, MA 02118. Telephone: 617-414-6198. E-mail: Joanne.Wilkinson@bmc.org.

Author Affiliation: Larry Culpepper, Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts.