In responding to the commentary on our article by Johnson et al., we would like to thank the authors for their effort to highlight the need for additional research in this field. While we agree diet, health beliefs, and other risk factors are certainly important factors and potential contributors to colorectal cancer (CRC) screening adherence, our parallel analysis of two separate, existing cohorts (Ohio Appalachia and the Southern Community Cohort Study) was not designed to capture many of these factors. The data common to both cohorts were specific to the original scope of those studies and were limited to individual and neighborhood characteristics as well as geographic region. We also agree there is a possibility that biological differences in CRC severity may be exacerbated by race/ethnicity, education, obesity, lifestyle/behavior, and lead to increased mortality. We would like to note that our findings of lower CRC screening rates associated with lower area-level and individual socioeconomic status likely support this given the reciprocal relationship these factors have with one's environment. Finally, while our study examined predictors associated with screening adherence within hotspots (areas with higher CRC mortality rates) and we suggested that this information could be used to inform future interventions, a comprehensive study examining both hotspot and non-hotspot areas would be informative. Furthermore, novel investigations such as comparing gut microbiota as suggested by Johnson et al., are imperative in driving future research and key to creating a comprehensive strategy to reduce CRC mortality.
Statements
Author contributions
SR: conceptualization and writing-original draft preparation. BB, AG, GY, RB, and WB: review and editing. EP: conceptualization, review and editing.
Funding
This article was funded by R01CA092447, U01CA202979 (SCCS); R24MD002785, P30CA016058, and Pelotonia (Ohio Appalachia).
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Summary
Keywords
guideline colorectal cancer screening, underserved population, neighborhood deprivation, guideline screening, correlates of screening
Citation
Reisinger SA, Bernardo BM, Gross AL, Young G, Baltic R, Blot WJ and Paskett ED (2020) Response: Commentary: Predictors of Colorectal Cancer Screening in Two Underserved U.S. Populations: A Parallel Analysis. Front. Oncol. 10:686. doi: 10.3389/fonc.2020.00686
Received
21 February 2020
Accepted
14 April 2020
Published
30 April 2020
Volume
10 - 2020
Edited by
Irit Ben-Aharon, Rambam Health Care Campus, Israel
Reviewed by
Michael Jon Pishvaian, Georgetown University, United States
Updates
Copyright
© 2020 Reisinger, Bernardo, Gross, Young, Baltic, Blot and Paskett.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Electra D. Paskett electra.paskett@osumc.edu
This article was submitted to Gastrointestinal Cancers, a section of the journal Frontiers in Oncology
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