David T Liss1, David W Baker2. 1. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Center for Advancing Equity in Clinical Preventive Services, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: david.liss@northwestern.edu. 2. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Center for Advancing Equity in Clinical Preventive Services, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Abstract
BACKGROUND: Prior studies have shown racial/ethnic disparities in colorectal cancer (CRC) screening but have not provided a full national picture of disparities across all major racial/ethnic groups. PURPOSE: To provide a more complete, up-to-date picture of racial/ethnic disparities in CRC screening and contributing socioeconomic and access barriers. METHODS: Behavioral Risk Factor Surveillance System data from 2010 were analyzed in 2013. Hispanic/Latino participants were stratified by preferred language (Hispanic-English versus Hispanic-Spanish). Non-Hispanics were categorized as White, Black, Asian, Native Hawaiian/Pacific Islander, or American Indian/Alaska Native. Sequential regression models estimated adjusted relative risks (RRs) and the degree to which SES and access to care explained disparities. RESULTS: Overall, 59.6% reported being up-to-date on CRC screening. Self-reported CRC screening was highest in the White (62.0%) racial/ethnic group; followed by Black (59.0%); Native Hawaiian/Pacific Islander (54.6%); Hispanic-English (52.5%); American Indian/Alaska Native (49.5%); Asian (47.2%); and Hispanic-Spanish (30.6%) groups. Adjustment for SES and access partially explained disparities between Whites and Hispanic-Spanish (final relative risk [RR]=0.76, 95% CI=0.69, 0.83); Hispanic-English (RR=0.94, 95% CI=0.91, 0.98); and American Indian/Alaska Native (RR=0.91, 95% CI=0.85, 0.97) groups. The RR of screening among Asians was unchanged after adjustment for SES and access (0.78, p<0.001). After full adjustment, screening rates were not significantly different among Whites, Blacks, or Native Hawaiian/Pacific Islanders. CONCLUSIONS: Large racial/ethnic disparities in CRC screening persist, including substantial differences between English-speaking versus Spanish-speaking Hispanics. Disparities are only partially explained by SES and access to care. Future studies should explore the low rate of screening among Asians and how it varies by racial/ethnic subgroup and language.
BACKGROUND: Prior studies have shown racial/ethnic disparities in colorectal cancer (CRC) screening but have not provided a full national picture of disparities across all major racial/ethnic groups. PURPOSE: To provide a more complete, up-to-date picture of racial/ethnic disparities in CRC screening and contributing socioeconomic and access barriers. METHODS: Behavioral Risk Factor Surveillance System data from 2010 were analyzed in 2013. Hispanic/Latino participants were stratified by preferred language (Hispanic-English versus Hispanic-Spanish). Non-Hispanics were categorized as White, Black, Asian, Native Hawaiian/Pacific Islander, or American Indian/Alaska Native. Sequential regression models estimated adjusted relative risks (RRs) and the degree to which SES and access to care explained disparities. RESULTS: Overall, 59.6% reported being up-to-date on CRC screening. Self-reported CRC screening was highest in the White (62.0%) racial/ethnic group; followed by Black (59.0%); Native Hawaiian/Pacific Islander (54.6%); Hispanic-English (52.5%); American Indian/Alaska Native (49.5%); Asian (47.2%); and Hispanic-Spanish (30.6%) groups. Adjustment for SES and access partially explained disparities between Whites and Hispanic-Spanish (final relative risk [RR]=0.76, 95% CI=0.69, 0.83); Hispanic-English (RR=0.94, 95% CI=0.91, 0.98); and American Indian/Alaska Native (RR=0.91, 95% CI=0.85, 0.97) groups. The RR of screening among Asians was unchanged after adjustment for SES and access (0.78, p<0.001). After full adjustment, screening rates were not significantly different among Whites, Blacks, or Native Hawaiian/Pacific Islanders. CONCLUSIONS: Large racial/ethnic disparities in CRC screening persist, including substantial differences between English-speaking versus Spanish-speaking Hispanics. Disparities are only partially explained by SES and access to care. Future studies should explore the low rate of screening among Asians and how it varies by racial/ethnic subgroup and language.
Authors: Rachel B Issaka; Maneesh H Singh; Sachiko M Oshima; Victoria J Laleau; Carly D Rachocki; Ellen H Chen; Lukejohn W Day; Urmimala Sarkar; Ma Somsouk Journal: Am J Gastroenterol Date: 2016-12-13 Impact factor: 10.864
Authors: Stephanie B Wheeler; Jennifer Leeman; Kristen Hassmiller Lich; Florence K L Tangka; Melinda M Davis; Lisa C Richardson Journal: Cancer J Date: 2018 May/Jun Impact factor: 3.360
Authors: Andrea N Burnett-Hartman; Shivan J Mehta; Yingye Zheng; Nirupa R Ghai; Dale F McLerran; Jessica Chubak; Virginia P Quinn; Celette Sugg Skinner; Douglas A Corley; John M Inadomi; Chyke A Doubeni Journal: Am J Prev Med Date: 2016-04-01 Impact factor: 5.043
Authors: Shira N Goldman; David T Liss; Tiffany Brown; Ji Young Lee; David R Buchanan; Kate Balsley; Ana Cesan; Jordan Weil; Bridget H Garrity; David W Baker Journal: J Gen Intern Med Date: 2015-03-27 Impact factor: 5.128
Authors: Karen E Kim; Fornessa Randal; Matt Johnson; Michael Quinn; Chieko Maene; Sonja Hoover; Valerie Richmond-Reese; Florence K L Tangka; Djenaba A Joseph; Sujha Subramanian Journal: Cancer Date: 2018-10-25 Impact factor: 6.860
Authors: Elisa K Tong; Tung T Nguyen; Penny Lo; Susan L Stewart; Ginny L Gildengorin; Janice Y Tsoh; Angela M Jo; Marjorie L Kagawa-Singer; Angela U Sy; Charlene Cuaresma; Hy T Lam; Ching Wong; Mi T Tran; Moon S Chen Journal: Cancer Date: 2016-08-26 Impact factor: 6.860