S586 Socioeconomic Disparities in Colorectal Cancer Screening Trends

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the U.S., with early detection crucial for improving outcomes. However, disparities in CRC screening rates persist among socioeconomically disadvantaged populations. This study evaluates screening trends from 2021 to 2024 to identify areas for public health improvement. Methods: We analyzed CRC screening data from the TriNetX network for 2021–2024, focusing on patients aged 45–75 without prior colon cancer diagnoses. Cohorts were stratified into those with socioeconomic challenges (n = 872,806; ICD10CM: Z55–Z65) and those without (n = 19,167,282). Incidence and prevalence rates were calculated and further stratified by gender, age, race, and ethnicity. Results: Patients with socioeconomic challenges had significantly higher average screening incidence (1.9%) and prevalence (15.4%) compared to those without (incidence: 0.9%, prevalence: 5.6%). However, prevalence among those with socioeconomic factors declined steadily, from 17.8% in 2021 to 11.6% in 2024. Stratified analysis revealed notable disparities: African Americans had the highest screening rates (incidence: 2.1%, prevalence: 14.3%), while Native Hawaiian and Other Pacific Islander populations had the lowest (incidence: 0.6%, prevalence: 4.5%). Men consistently lagged behind women in screening rates, and younger adults (45–49) showed high incidence (1.6%) but low prevalence (6.7%), indicating gaps in sustained care. Conclusion: Public health interventions have improved CRC screening rates among socioeconomically disadvantaged populations. However, disparities persist, particularly among men, Native Hawaiian/Other Pacific Islander populations, and younger age groups. Addressing these gaps through targeted outreach and equitable healthcare policies is critical for improving CRC prevention and health equity.