Racial, ethnic, socioeconomic disparities persist in CRC screening

CHICAGO — Despite improved access to care, racial, ethnic and socioeconomic disparities persist in colorectal cancer screening, particularly among Hispanic people, according to a presentation at Digestive Disease Week.

“In terms of colorectal cancer screening by race, although colorectal cancer continues to be the second leading cause of cancer-related death in the U.S., screening rates continue to be low among minority populations,” Nicolette Rodriguez, MD, MPH, from the department of internal medicine at Yale University School of Medicine, said at the meeting. “Despite the expansion of health care insurance through the Affordable Care Act, research still needs to be conducted on the effects of colorectal cancer screening rates.”

Researchers analyzed 2015 data from the Behavioral Risk Factor Surveillance System to determine the racial and ethnic prevalence of health-related characteristics with history of colorectal cancer screening among 42,693 U.S. adults aged 50 to 75 years. Adults were included in the study if they reported history of colonoscopy, sigmoidoscopy or fecal occult blood testing.

Of the 42,693 individuals included in this study, approximately 33,569 reported history of CRC screening. The researchers found that Hispanic patients were the least likely to receive recommended CRC screenings (adjusted OR = 0.76; 95% CI, 0.61-0.95). The results showed that white patients had the highest percentage of self-reported screenings (77%), followed by black patients (72%), other groups (72%) and Asian populations (70%), while the Hispanic group had the lowest rate (61%).

Factors such as history of smoking, lack of an established primary care provider (aOR = 0.3; 95% CI, 0.26-0.35) and lack of health insurance (aOR = 0.42; 95% CI, 0.35-0.51) were associated with reduced chances of CRC screenings. The investigators also observed that adults with lower annual salaries and level of education were less likely to receive CRC screenings, detecting a step-wise decline when stratified by income level. Those with an annual income less than $15,000 (aOR = 0.68; 95% CI, 0.56-0.83) and those who did not graduate high school (aOR = 0.49; 95% CI, 0.4-0.58) were the least likely to pursue CRC screening. Certain socioeconomic factors, such as sex and a history of binge alcohol use, were not linked to changes in screening patterns.

“Despite improved access to care, there continues to be large racial, ethnic and socioeconomic disparities when it comes to colorectal cancer screening,” Rodriguez said. “It’s crucial that future studies examine the specific barriers to specific minority groups and, therefore, interventions can be targeted for these barriers. It’s critical for us as providers to understand our local resources and understand whether or not these local resources that we have in our own communities can help our patients overcome barriers for colorectal cancer screening.” – by Talitha Bennett and Savannah Demko

References:

Rodriguez N, McCarty TR. Abstract 85. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.

Disclosure : Rodriguez reports no relevant financial disclosures.