S640 From Flu Shots to Colonoscopies: What Drives Screening in Women Veterans?

Introduction: Colorectal cancer (CRC) is the fourth-leading cause of cancer-related death among U.S. women and the second among those under 50. Despite rising incidence, CRC screening rates remain below the national goal of >80%. Although studies have explored screening disparities, none have specifically evaluated screening practices in women veterans. This study compares compliance with CRC screening and other preventive health practices among women veterans, aiming to help identify individuals at risk of missed screenings and to guide targeted outreach. Methods: Retrospective analysis was conducted at a Veterans Affairs (VA) facility in Hines, IL. Women's Health Clinic (WHC) patients ages 45-75, female-at-birth and with CRC screening data from the past ten years were included. Age, influenza vaccination, and screening status for CRC, breast cancer, and cervical cancer were obtained from the VA’s Electronic Quality Management system. Screening status was defined by VA Electronic Technical Measure specifications. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated in RStudio©. Results: Of 1,333 patients, 43.4% identified as Black, 32.7% White, 15.9% Hispanic, 1.4% Asian, 6.6% other. 724 had CRC screening data (78.7% met). Among these 724, screening data was available for breast cancer (n = 563, 81.7% met), cervical cancer (n = 404, 81.7% met), and flu vaccination (n = 724, 42.5% met). CRC screening was significantly more likely in women veterans compliant with screenings for breast cancer (odds ratio [OR] 3.78, CI 2.79–5.11), cervical cancer (OR 1.97, CI 1.39–2.80), and flu vaccination (OR 1.92, CI 1.39–2.64), all P < 0.001. Age was not a significant predictor for CRC screening (adjusted OR 1.008, P = 0.500). Conclusion: Among women veterans, compliance with other preventive health practices is associated with increased CRC screening. While this association has been observed within the general population, it has not been explored in women veterans. Such findings highlight an opportunity to leverage existing healthcare encounters to encourage CRC screening. Additionally, higher CRC compliance in women veterans (78.7%) vs civilian women (73.9%) and male veterans within the same VA (66.9%) may reflect unique systematic processes within the VA’s WHC. Although this study does have limitations—retrospective analysis and reliance on databases—the results underscore a promising avenue for intervention to maximize CRC screening rates.