DOI: 10.1177/13524585261465197 ISSN: 1352-4585

Colorectal cancer screening in individuals with multiple sclerosis: A mixed-methods study

Chloé Pierret, Romane Bouvier, Sandrine Kerbrat, Emmanuelle Leray
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Introduction:

People with multiple sclerosis (pwMS) have a lower reported risk of colorectal cancer, which may reflect reduced access to colorectal cancer screening (CCS).

Objectives:

Compare CCS in pwMS and the general population and identify barriers and facilitators using mixed methods.

Methods:

In 2022–2024, PwMS aged 50–74 years and matched controls (3:1) were selected. Overall and age-stratified CCS coverage rates were computed. In pwMS, multivariable mixed-effects logistic models identified factors associated with CCS ⩾ 80%. Semi-structured interviews were carried out with 20 pwMS.

Results:

The cohort included 63,509 pwMS and 190,527 controls (72.0% women, mean age 59.2 years). Annual CCS coverage was 41.2% in pwMS and 42.4% in controls ( p  < 0.001). In pwMS, CCS was higher in the 50–54 years (+1.5%, p  < 0.001) and lower in the ⩾65 years group (−1.6% to −6.2%, p  < 0.001). Male sex (odds ratio = 0.90; 95% CI = [0.86–0.93]) and lower ecological socioeconomic status (0.81 [0.76–0.86]) were associated with lower CCS, while disease-modifying therapies (1.12 [1.08–1.16]) and high healthcare use with higher CCS. Qualitative barriers included motor or digestive MS symptoms and feelings of disgust. Facilitators included health system trust and prevention awareness.

Conclusion:

CCS is lower among older pwMS and remains suboptimal in both pwMS and controls.

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