Trends in self-reported health care provider recommendations for colorectal cancer screening by race

Abstract

Objective To examine whether a racial difference exists in self-reported recommendations for colorectal cancer screening from a health care provider, and whether this difference has changed over time. Method Secondary analysis of the 2002, 2004, 2006, and 2008 Maryland Cancer Surveys, cross-sectional population-based random-digit-dial surveys on cancer screening. Participants were 11,368 White and 2495 Black Maryland residents age ≥ 50 years. Results For each race, recommendations for colonoscopy/sigmoidoscopy increased over time (67%–83% for Whites, 57%–74% for Blacks; p < 0.001 for both), but the race difference remained approximately 10% at each survey. Among respondents without a colonoscopy in the last 10 years (n = 5081), recommendations for fecal occult blood test (FOBT) in the past year decreased over time for Whites (37%–24%, p < 0.001) and for Blacks (36–28%, p = 0.05), with no difference by race in any year. In multivariable analysis, the effect of race on the odds of reporting a provider recommendation did not vary significantly across time for either test (p = 0.80 for colonoscopy/sigmoidoscopy, p = 0.24 for FOBT for effect modification by year). Conclusion Whites were more likely than Blacks to report ever receiving a provider recommendation for colonoscopy/sigmoidoscopy. Although the proportion of patients receiving recommendations for colonoscopy/sigmoidoscopy increased over time, the gap between races remained unchanged.