Charles R. Rogers

Supplementary Figure S3 showsed the association between race/ethnicity, cancer history, lack of social support, and CRC screening utilization adjusted for sociodemographic characteristics

In Supplementary Figure S1, seven exclusion criteria were applied based on the study purpose. As a result, 73,869 eligible participants were included for full analyses.

Supplementary Table S1 showed the characteristics of excluding and including participants

Supplementary Figure S4 showed the association between race/ethnicity, cancer history, lack of social support, and CRC screening utilization adjusted for sociodemographic characteristics and health-related factors

Supplementary Figure S2 showed the association between race/ethnicity, cancer history, lack of social support, and CRC screening utilization

Background:Colorectal cancer among adults aged <50 years [early-onset colorectal cancer (EOCRC)] is projected to be the leading cause of cancer-related death by 2030. Although evidence-based guidelines for colorectal cancer screening now recommend beginning screening at age 45, the needs of many at-risk young adults are potentially being overlooked. Unanswered questions also remain regarding the effects of EOCRC on quality-of-life and psychosocial outcomes. This qualitative study explored the lived experiences and perceptions of a sample of adult EOCRC survivors in the United States through one-on-one interviews.Methods:An EOCRC advocate survivor team member led 27 structured virtual interviews using a 10-question interview guide. Data were analyzed using a 9-step inductive approach.Results:Participants were geographically diverse. Most were women (66.6%) who self-identified as non-Hispanic White (85.2%). The mean age at interview was 40.19 ± 5.99; at diagnosis, 33.93 ± 5.90. Six overarching themes emerged: signs and symptoms, risk factors, system-level factors, quality of life, social support, and reflection.Conclusions:The specific needs of individuals in this younger population of patients with colorectal cancer should be considered during treatment and future interventions and throughout survivorship.Impact:While the reasons for the increasing incidence of EOCRC are currently unknown, the lived experiences and perceptions of EOCRC survivors noted in this study highlight specific needs of this population that can inform educational materials, comprehensive care, future research, and policy change.

Success in community-based interventions addressing colorectal cancer (CRC) disparities among men relies on their active engagement in screening activities, yet traditional masculinity norms may deter men from participating in preventive health behaviors. This cross-sectional study examined the association between masculinity barriers to medical care (MBMC) and CRC-screening intent and behaviors among men aged 18-75, attending state fairs in 2 midwestern states. CRC-screening intent was assessed for all participants. Screening participation and current screening status were also examined among men aged 45-75 years (screening-age eligible). Composite scores were calculated overall and for each MBMC subscale, with higher scores indicating a stronger endorsement of traditional masculine ideologies. Multivariable logistic regression was employed, adjusting for confounders. Our findings highlight a high prevalence of self-reported CRC-screening behaviors among men in our study sample (n = 937), with 78% expressing intentions to obtain screening. Among screening-age eligible men (n = 377), 79% reported having participated in CRC screening, with 72% being up-to-date (UTD) with screening. A strong inverse relationship was observed between CRC-screening intention and behaviors, and the Health Problem Minimization subscale as well as Fear of Being Perceived as Gay subscale. Conversely, higher scores on the Provider Role subscale were associated with higher odds of having ever participated in CRC screening, and of being UTD with screening. Addressing masculinity-related barriers, particularly Health Problem Minimization, could help increase CRC screening uptake among men. Future intervention strategies should consider reframing CRC screening as an act of self-care and strength, emphasizing health empowerment rather than aligning solely with traditional masculine or provider-role ideologies, which may themselves present limitations. By promoting a broader and more inclusive view of masculinity, interventions can better engage men in preventive health behaviors and ultimately improve CRC-screening adherence and outcomes.

Background: Despite evidence of the benefit of routine cancer screenings, data show a concerning decline in cancer screening uptake for multiple cancers. This analysis aimed to examine rural-urban differences in recent trends for being up-to-date with screenings for breast, cervical, and colorectal cancers. Methods: We used 2018, 2020, and 2022 Behavioral Risk Factor Surveillance System data to assess up-to-date cancer screening status among eligible adults in the United States. We calculated weighted prevalence estimates overall and stratified by county-level rural-urban classification. We used survey-weighted multivariable logistic regression models to examine rural-urban disparities in cancer screening up-to-date status by year. Results: Prevalence of being up-to-date with each cancer screening was lower in 2022 than it was in 2018. The largest decline in screening overall was for cervical cancer, which dropped from 81.89% in 2018 to 47.71% in 2022. Rural-urban disparities were observed for breast cancer screening from 2018 to 2022, with the odds of up-to-date screening being 14% to 27% lower for rural populations than for urban populations. For colorectal and cervical cancers, the odds of being up-to-date with screenings were lower for rural populations in 2018 and 2020, but no statistically significant difference was observed in 2022 (colorectal screening odds ratio = 0.96, 95% CI = 0.90 to 1.02; cervical screening odds ratio = 0.97, 95% CI = 0.93 to 1.03). Conclusion: There is a concerning trend of decreasing uptake of cancer screenings that will challenge future efforts in cancer prevention and control. There is a need to better understand the factors contributing to the decline in cancer screening update.

In Supplementary Figure S1, seven exclusion criteria were applied based on the study purpose. As a result, 73,869 eligible participants were included for full analyses.