Racial/ethnic disparities in colorectal cancer screening methods: Unveiling patterns and implications.

Abstract

124 Background: Colorectal cancer screening (CRC) is crucial for reducing morbidity and mortality of CRC. The type of screening method chosen is important for accessibility, compliance, and effectiveness. Colonoscopy and sigmoidoscopy are considered the gold standard while fecal occult blood tests (FOBT) are non-invasive, inexpensive, and more available. Our study examined the racial/ethnic disparities associated with various CRC screening methods. Methods: We utilized the cross-sectional nationally representative data from the 2018-2021 Behavioral Risk Factor Surveillance System (BRFSS). The sample included individuals between 50-75 years, the recommended age for CRC screening. Logistic regression analysis was performed to investigate up-to-date CRC screening rates and the choice of CRC screening method in related to race/ethnicity, after controlling for confounding factors. Results: Among the weighted population of 119,841,048 individuals aged 50-75 years, 44.6% reported having an up-to-date colonoscopy/sigmoidoscopy only, 5.0% had only FOBT in the past year, and 5.8% had both tests. The logistic regression models revealed that Asians and Pacific Islanders (APIs; adjusted odds ratio [aOR]: 0.59; 95%CI: 0.49-0.69), American Indians and Alaska Natives (AIs/ANs; aOR: 0.73; 95%CI: 0.59-0.90), and Hispanic individuals (aOR: 0.76; 95%CI: 0.69-0.84) were less likely to undergo colonoscopy/sigmoidoscopy only compared to non-Hispanic White (NHW) peers. Conversely, APIs (aOR: 1.46; 95%CI: 0.98-2.17) and Hispanic individuals (aOR: 1.46; 95%CI: 1.20-1.79) were associated with a higher rate of recent FOBT only compared to their NHW individuals. Regarding the combination of up-to-date colonoscopy/sigmoidoscopy and FOBT, non-Hispanic Blacks (NHB; aOR: 1.66; 95%CI: 1.44-1.92) and Hispanic individuals (aOR: 1.61; 95CI: 1.33-1.95) were more likely to have both tests compared to NHW individuals. Conclusions: Our findings highlight the significant variations in CRC screening preferences among different racial/ethnic groups, which are likely influenced by cultural backgrounds, health literacy and access, and language barriers. It is crucial for healthcare providers to acknowledge these differences, as they can significantly impact patient engagement and compliance with CRC screening recommendations. Emphasizing culturally informed approaches to CRC screening is essential for fostering trust, promoting equitable healthcare, and ultimately reducing disparities in CRC outcomes.