Colon Cancer Screenings Low Among Blacks’
According to researchers in California, Colon Cancer Screenings is Low Among Blacks’. The use of colonoscopy to look for colon cancer is infrequent despite similar access to care across races in a Veterans Affairs healthcare system. The researchers also found that having established primary care at the time of screening eligibility significantly increased screening uptake. The study appears in the August issue of Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Although CRC affects all racial and ethnic groups, African Americans carry an excessive burden of disease with the highest overall incidence, highest incidence of advanced stage at presentation, highest mortality, and lowest survival rates compared to any other ethnic or racial group. Although CRC incidence has decreased by 10 percent among whites in the past 30 years, rates have remained unchanged among African Americans over the same period.
The specific causes of CRC outcome inequalities in African Americans are not fully characterized. Biological susceptibility, a diet higher in fats and red meats, increased likelihood of smoking, social and economic disparities, and low use of screening methods have been implicated as potential contributing causes. Particular attention has been paid to low adherence to screening guidelines among African Americans, and multiple studies demonstrate that African Americans are less likely to engage in CRC screening than non-African Americans.
The Veterans Affairs (VA) health system presents an ideal model to test whether patient and provider factors affect CRC screening after controlling for system-level factors. Because access inequalities are minimized in the VA setting and given recent studies indicating fewer disparities in CRC treatment in VA settings, it is possible that CRC screening rates are equal among races in the VA population. However, the extent to which disparities in screening adherence currently exist in the VA population is unknown.
“We aimed to determine the rates of screening uptake and time to screening uptake in African American and non-African American veterans in a large VA health care system database. In addition, we sought to identify modifiable predictors of CRC screening in non-African American and African American veterans by using a conceptual framework accounting for a wide range of clinical and demographic characteristics,” said study lead author Fola May, MD, MPhil, VA Greater Los Angeles Healthcare System. “We found marked disparities in CRC screening despite similar access to care across races. Participation in screening remained low and use of colonoscopy was infrequent despite current guidelines aimed at increasing CRC screening in African Americans. When adjusting for race, homelessness, low service connectedness, and greater use of prescription drugs, the lack of a primary care visit within two years of CRC screening eligibility independently predicted low screening. Notably, individuals with a primary care visit within two years of CRC screening eligibility were nearly four times more likely to have had at least one CRC screening test.”
Click here to view original web page at www.sciencedaily.com
Category: Articles
