Folasade P May1, Liu Yang2, Edgar Corona2, Beth A Glenn3, Roshan Bastani3. 1. Tamar and Vatche Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California. Electronic address: fmay@mednet.ucla.edu. 2. Tamar and Vatche Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. 3. Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
Abstract
BACKGROUND & AIMS: Colorectal cancer (CRC) is major cause of cancer-related mortality in the United States. Screening, however, is suboptimal and there are disparities in outcomes. After health policy changes and national efforts to increase rates of screening and address inequities, we aimed to examine progress towards eliminating racial and ethnic disparities in CRC screening. METHODS: We conducted a repeated cross-sectional analysis of average-risk adults (age 50-75 years) included in the behavioral risk factors surveillance system survey. The main outcome was CRC screening status. We determined screening rates overall and by race and ethnicity (1 variable) for each survey year from 2008 through 2016 and used Joinpoint analyses to determine significant trends in rates over time by race and ethnicity. We also examined screening modalities used overall and by race and ethnicity. RESULTS: We analyzed data from 1,089,433 respondents. Screening uptake was 61.1% in 2008 and 67.6% in 2016 (P < .001); it was highest among whites and lowest among Hispanics. Only whites, Hispanics, and Asians had significantly higher screening rates in each study year (P < .001). Despite increasing rates among Hispanics, the screening rate disparity between whites and Hispanics was 17% at the end of the study period. Screening rates in blacks did not change with time and were 4.0% lower than the rate in whites in 2016. Other racial and ethnic groups had varying levels of improvement with time. Colonoscopy was the most common modality each year. CONCLUSIONS: In a cross-sectional analysis of average-risk adults, we found that although rates of CRC screening have increased overall since 2008, they have increased disproportionately in each racial and ethnic group, and disparities in screening uptake persist.
BACKGROUND & AIMS:Colorectal cancer (CRC) is major cause of cancer-related mortality in the United States. Screening, however, is suboptimal and there are disparities in outcomes. After health policy changes and national efforts to increase rates of screening and address inequities, we aimed to examine progress towards eliminating racial and ethnic disparities in CRC screening. METHODS: We conducted a repeated cross-sectional analysis of average-risk adults (age 50-75 years) included in the behavioral risk factors surveillance system survey. The main outcome was CRC screening status. We determined screening rates overall and by race and ethnicity (1 variable) for each survey year from 2008 through 2016 and used Joinpoint analyses to determine significant trends in rates over time by race and ethnicity. We also examined screening modalities used overall and by race and ethnicity. RESULTS: We analyzed data from 1,089,433 respondents. Screening uptake was 61.1% in 2008 and 67.6% in 2016 (P < .001); it was highest among whites and lowest among Hispanics. Only whites, Hispanics, and Asians had significantly higher screening rates in each study year (P < .001). Despite increasing rates among Hispanics, the screening rate disparity between whites and Hispanics was 17% at the end of the study period. Screening rates in blacks did not change with time and were 4.0% lower than the rate in whites in 2016. Other racial and ethnic groups had varying levels of improvement with time. Colonoscopy was the most common modality each year. CONCLUSIONS: In a cross-sectional analysis of average-risk adults, we found that although rates of CRC screening have increased overall since 2008, they have increased disproportionately in each racial and ethnic group, and disparities in screening uptake persist.
Authors: Bianca Aibuedefe; Kendall S Hamilton; Valeda Yong; Sarah M Kling; Huaqing Zhao; Juan L Poggio Journal: Ann Surg Oncol Date: 2022-03-30 Impact factor: 5.344
Authors: Carolyn M Rutter; Amy B Knudsen; Jennifer S Lin; Kathryn E Bouskill Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-11-03 Impact factor: 4.090