Colorectal Cancer Screening in Black and Latino Adults with Type 2 Diabetes: Associations with Modifiable Health Behaviors and Sociodemographic Factors

OBJECTIVE: Black and Latino adults with type 2 diabetes (T2D) face an elevated risk of colorectal cancer (CRC) yet remain less likely to receive guideline-recommended screening. This study examined predictors of CRC screening among these patients. METHODS: Electronic health records from 2017 to 2025 were reviewed for adults aged 45 to 74 years with T2D who self-identified as Black or Latino. This study examined the associations between CRC screening and sociodemographic variables, healthcare access and utilization, health behaviors, preventative care indicators, and clinical characteristics. RESULTS: Of the 723 adults in the sample, 36.1% were up-to-date with CRC screening. In adjusted analyses, AOR[CI 95%], higher clinic encounters 1.04[1.02-1.06], receiving the COVID-19 vaccine 1.73[1.18-2.52], having a GI condition 1.52[0.99-2.31], and being 2.10[1.10-3.90] were positively associated with CRC screening. However, current cigarette smoking was associated with lower odds of screening 0.41[CI, 0.22-0.77]. Sociodemographic factors were not significant predictors after multivariate adjustment. CONCLUSIONS: In this cohort, CRC screening was more strongly associated with modifiable health behaviors and healthcare engagement than with sociodemographic characteristics. Integrating tailored screening outreach within routine diabetes care may enhance screening rates in high-risk populations.