Trends and factors associated with fecal occult blood test utilization among Hispanic adults in Puerto Rico and the United States: BRFSS 2012-2020.

Identifying factors associated with colorectal cancer (CRC) screening utilization is important to guide CRC prevention and control programs. We evaluated trends and factors associated with previous-year fecal occult blood test (FOBT) use among Hispanic adults living in Puerto Rico and the US mainland. Using data from the Behavioral Risk Factor Surveillance System (2012-2020), trends in FOBT use were analyzed using joinpoint regression to estimate annual percentage change (APC). Logistic regression stratified by location identified factors associated with FOBT use. FOBT was more common among Hispanic adults aged 50-75 years living in Puerto Rico than in the US mainland [Puerto Rico: 20.5%[2012] to 45.6%[2020], APC=11.4%; US mainland: 9.9%[2012] to 16.7%[2020], APC=5.9%]. Factors inversely associated with FOBT use were similar in Puerto Rico and the US mainland, including lack of health insurance, not having a personal doctor, having a checkup >12 months ago, and not being able to see a doctor due to cost, as were factors associated with higher FOBT use, including older age, retirement or having two or more chronic diseases. Among Hispanics living in the US mainland, lack of exercise and less education were inversely associated with FOBT. Factors related to poor access to healthcare were associated with lower use of FOBT among Hispanics. Efforts to improve CRC screening in Hispanics are necessary to address health disparities across the CRC care continuum.