Prevalence of colorectal cancer screening among a multimorbid rural appalachian population

Steven T. Fleming, Nancy E. Schoenberg, Yelena N. Tarasenko, Kevin A. Pearce

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


OBJECTIVES: The purpose of this study was to determine the relation among multiple morbidities and the prevalence of colorectal cancer (CRC) screening among older adult Appalachian residents of Kentucky. This is the first known study to address multiple morbidities exclusively with a health-disparities population. METHODS: This was a cross-sectional study of 1153 subjects, aged 50 to 76 years, from Appalachian Kentucky. RESULTS: White race, post-high school education, and perception of having more than enough income on which to survive were associated with higher rates of any guideline concordant CRC screening. Statistically significant trends in the outcome of adjusted odds ratios for colonoscopy with greater number of morbidities (P < 0.05) were noted; the higher number of morbidities, the higher rates of screening. CONCLUSIONS: Contrary to much existing research, within a health-disparities population, we found a dose-response relation between comorbidities and greater likelihood of CRC screening. Future research in this area should focus on explanations for this seldom-described finding. In addition, this finding has meaningful clinical and behavioral implications, including ensuring provider screening recommendation during routine office visits and outreach, perhaps through community clinics and public health departments, to extremely vulnerable populations lacking access to preventive care.

Original languageEnglish
Pages (from-to)811-818
Number of pages8
JournalSouthern Medical Journal
Issue number12
StatePublished - Dec 2011


  • colorectal cancer
  • epidemiology
  • multimorbidity
  • screening

ASJC Scopus subject areas

  • General Medicine


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