ArticlePloS one2025
Mediating effects of mental and physical health on the association between chronic disease conditions and colorectal cancer screening utilization among breast cancer survivors.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Multilevel insights into obesity, race/ethnicity, and survival in early-onset colorectal cancer in Georgia.Cancer causes & control : CCC · 2026Article
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Authors and funding
6 authors.
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Abstract
purposeBreast cancer survivors have an increased risk of colorectal cancer (CRC) and those with chronic diseases are more likely to experience poor mental and physical health. For this study, we examined the mediating effects of mental and physical health on the association between chronic disease conditions and guideline-concordant colorectal cancer (CRC) screening among breast cancer survivors.
methodsWe included 1,885 breast cancer survivors aged 45-75 years who were eligible for CRC screening in 2016, 2018, and 2020 Behavioral Risk Factor Surveillance System. The exposure was chronic diseases defined as prevalent diabetes, coronary heart disease/myocardial infarction, stroke, chronic obstructive pulmonary disease, emphysema/chronic bronchitis, arthritis, depressive disorders, or kidney diseases. The outcome was receipt of guideline-concordant CRC screening. Mediators were defined as self-reported frequent poor mental/physical health in the past 30 days (14-30 vs. 0-13 days). Multivariable logistic regression models were adjusted for sociodemographic and cancer-related factors. We used the methods proposed by Valeri & VanderWeele for the mediation analyses.
resultsBreast cancer survivors with chronic diseases were 1.7-fold more likely to have CRC screening compared to those without any chronic diseases (OR, 1.68; 95% CI, 1.27-2.21). In mediation analysis, we found that frequent poor mental health mediated the association between chronic disease conditions and CRC screening utilization (-4.4% mediated; p-value = 0.035). We also observed a reduction through frequent poor physical health by 10.5% (p-value = 0.008).
conclusionsFrequent poor mental and physical health negatively mediated the association between the presence of chronic diseases and CRC screening utilization with a higher estimate for those with poor physical health. Effective implementation of integrated follow-up care is needed among breast cancer survivors to address chronic disease management and prioritize mental and physical health so that all patients receive guideline concordant CRC screening recommendations.
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