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Despite increases in CRC screening, racial disparities persist
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Health policy changes and a concerted, national effort have led to an overall increase in rates of colorectal cancer screening in the last decade. However, racial and ethnic disparities have persisted, according to study results.
“While an overall improvement in screening rates should be acknowledged, our findings demonstrate that not all racial/ethnic groups benefited equally over time,” Folasade (Fola) P. May, MD, PhD, of the Tamar and Vatche Manoukin Division of Digestive Diseases at UCLA, and colleagues wrote. “Further, there are some groups, namely blacks and [American Indian or Alaska Natives], where improvements in screening disparities have stalled.”
Researchers conducted a reported cross-sectional analysis of average-risk adults who were included in the behavioral risk factors surveillance system survey to explore progress toward eliminating racial disparities in CRC screening in the United States. They analyzed data from 1,089,433 individuals to determine screening rates overall and by race for each survey year from 2008 to 2016.
Overall, screening uptake increased from 61.1% in 2008 to 67.6% in 2016 (P < .001). White patients had higher screening rates than all other groups for each year, while black patients had the second highest rates in all years except for 2016. Hispanic patients had the lowest rates in all years except 2012.
The disparity between white patients and some racial or ethnic groups decreased over the course of the study period, including among Hispanic patients (19.2% to 17%), Asian patients (12.8% to 7.2%), Native Hawaiians or Pacific Islanders (3.7% or 1.4%) and multiracial/other (9.3% to 4.3%). However, the disparity in screening increased among black patients (3% to 4.3%) and American Indian or Native Alaskan patients (8.7% to 11%).
May and colleagues wrote that the increase in CRC screening rates could be due to several factors, like increased national attention and changes to health policy, including the implementation of the Affordable Care Act. They also wrote that that their findings highlight areas that need more attention.
“In order to achieve national screening goals, we must further diversify screening modalities, particularly in populations and settings where access to colonoscopy is limited,” they wrote. “Our findings also emphasize for researchers, providers, and policy-makers a need to optimize implementation and dissemination of evidence-based interventions, especially in settings where racial/ethnic minorities are more likely to receive health care.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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