305548
Race disparities in colonoscopy screening among persons with a family history of colorectal cancer
Methods: To investigate racial differences in colonoscopy screening among Americans with a CRC family history using data from the National Health Interview Survey 2010.
Results: Of 6,344 respondents to questions on CRC family history, 1,124 (17.7%) reported a CRC family history (mean age 62.3 (SD: 12.6)). Of 1,124 respondents 46.2% had a colonoscopy in the previous 5 years (49.3% among Whites and 34.5% among AAs). Among the 40-49 age group, AAs had 45.7% lower colonoscopy rates than Whites (20% vs. 36.8%). Disparity persists in older age groups but reduced to 24.9% in the 65-plus age group. Multivariate analysis showed that after accounting for socio-demographic factors and insurance status, AAs and Whites with high school or less education were 68% and 33% less likely than Whites with a bachelor’s degree or higher to have been screened. There were no racial differences in screening likelihood among categories with any college education. Respondents aged 40-49 years were 40% less likely to be screened than the 50-64 age group. Insurance type was a major predictor; those with Medicare (alone or in combination) had the highest likelihood of being screened (OR range, 5.0 to 5.6) relative to the uninsured.
Conclusion: Significant racial disparity in screening exists, particularly in the 40-49 age group. Education and insurance are the key mediating factors. Studies after 2015 will indicate whether the Affordable Care Act narrows the disparity. Targeted patient navigation may increase screening rates among less educated and younger Americans with CRC family history.
Learning Areas:
Chronic disease management and preventionPlanning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines
Learning Objectives:
Compare colonoscopy screening rates of African Americans and Whites with a family history of colorectal cancer
Discuss mediating factors in screening disparities
Keyword(s): Cancer Prevention and Screening, Health Disparities/Inequities
Qualified on the content I am responsible for because: I am the main contributor of the abstract.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.