Franklin on the Investigation of Social Needs and Screening Rates in CRC

Isabelle Franklin, medical student, Kaiser Permanente Bernard J. Tyson School of Medicine, discusses the correlation between self-reported social needs and colorectal cancer (CRC) screening.

In a cross-sectional study presented at the 2023 ASCO Annual Meeting, investigators evaluated 3,443 patients between 50 and 75 years of age from Kaiser Permanente who completed the Kaiser Permanente National Social Needs Survey in 2020. Data from the investigation showed that patients with financial strain well and social isolation were more likely to not undergo screening.

This investigation looked at patients’ self-reported social needs, including financial strain, housing instability, transportation issues, social isolation, and food insecurity, all within the Kaiser Permanente patient population, Franklin begins. Notably, CRC is one of the leading causes of cancer death in the United States. However, consistently lower rates of CRC screenings have been reported compared with those for breast or cervical cancer, Franklin explains. Many studies have been previously conducted to identify driving factors behind these lower screening rates, as have several large systematic reviews of patient-reported barriers to CRC screenings, Franklin adds. Based on this research, social determinants of health have emerged as some of the principal driving factors behind low screening rates.

Due to the modifiable nature of social determinants of health, these are an ideal target for quality improvement-focused research, Franklin expands. However,although these patient-reported barriers have previously been described, few studies have analyzed how these barriers and social needs affect screening rates, such as those for CRC, she notes.

This unique dataset from Kaiser Permanente is due to the robust electronic health record, granting investigators access to a large amount of data. Due to this large amount of data, investigators were able to link those patient-reported survey data to their electronic medical record screening status, providing a clearer picture of what patient-reported needs and social needs are linked to lower screening rates, Franklin explains. The goal of this research is to inform future quality improvement efforts within the Kaiser Permanente region, resulting in improved cancer screening rates, Franklin concludes.