Abstract B111: Disparities in colorectal cancer: Who receives screening?

Abstract

Abstract Background: Colorectal cancer is a leading cause of cancer morbidity and mortality in the United States. It is estimated that approximately 142,570 new cases of colorectal cancer will be diagnosed and over 51,000 will die in 2010. Further, African Americans are diagnosed at later stages and suffer disproportionately higher mortality rates from colon cancer. Despite the increased attention to the importance of colorectal cancer screening, the American Cancer Society reports half of the US population has not been tested. The purpose of this study was to examine the characteristics of individuals who receive three common screening methods for colorectal cancer: Fecal occult blood test (FOBT), sigmoidoscopy and colonoscopy Methods: Data were drawn from the 2007 Health Information National Trends Survey (HINTS). Following the American College of Gastroenterology Guidelines, a total of 4,464 participants aged from 45 to 75 years were selected for secondary data analysis. The selected sample included both men and women participants whose mean age was 58.89 (±8.41) with approximately 59.7% female, 74.1% Caucasian and 9.3% African American. Logistic regressions were performed to determine significant predictors of having fecal occult testing, colonoscopy, and sigmoidoscopy. Results: Odds of having FOBT, colonoscopy or sigmoidoscopy was increased among older individuals with higher education. FOBT was higher among females and those with insurance compared to those without (both p<.05). Colonoscopy was higher among those with insurance and higher income (p<.001). Having a sigmoidoscopy was more likely among those with higher income, but differed among subgroups. There were significant interaction effects of gender by age and race by gender in having a sigmoidoscopy. Both males and females had higher log odds of having a sigmoidoscopy among older individuals, compared to younger individuals, but the age difference was more pronounced among females. The odds of having a sigmoidoscopy were much lower among African American men than other groups. Conclusion: Those who were older and more educated are more likely to participate in colorectal screening. Higher income was associated with both colonoscopy and sigmoidoscopy screening procedures with insurance also being significant for colonoscopy. African American men, who are at greater risk for colorectal morbidity and mortality, are significantly less likely to have participated in screening using a sigmoidoscopy. Socioeconomic dividers which often parallel health disparities e.g. income, education and insurance are similarly associated with colorectal cancer screening participation. Understanding the characteristics of individuals who choose to participate in colorectal cancer preventive screenings could contribute to the development of interventions and or policies geared toward those who do not. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B111.