The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64735

Olufemi J. Adegoke, MBChB, MPH, DrPH¹, Mathew Garvin, MPH¹, Selwyn O. Rogers, MD², Steven C. Stain, MD¹, and RS Levine, MD³. (1) Department of Surgery, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, 615-327-5689, oadegoke@mmc.edu, (2) Department of Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, (3) Department of Family and Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208

PURPOSE: To determine differences in colorectal cancer (CRC) hospitalizations and the usage rate of diagnostic procedures for CRC among blacks and whites. METHODS: Study population: Sample of the United States:- 80,238 blacks and 877,219 whites CRC hospitalizations from 1979-1987 (Period I) in the National Hospital Discharge Survey (NHDS) and 103,238 blacks and 960,480 whites CRC hospitalizations from 1988-2000 (Period II) in the NHDS. CRC definition: International Classification of Diseases, 9th Revision (ICD-9) codes 153.X, 154.X. Screening method: ICD-9 procedure codes 4523 (colonoscopy) and 4524 (flexible sigmoidoscopy). Barium enema (code 9639) was rarely done on hospitalized CRC patients. Analyses: Statistical Analysis Software (SAS), vs. 8.2. All rates are age-sex-adjusted. RESULTS: The proportion of blacks hospitalized for CRC increased significantly from 8.4% in Period I to 9.7% in Period II (p<0.0001). The average discharge rate ratio for whites to blacks was 1.71:1.00 in Period I but reduced to 1.47:1.00 in Period II. In-hospital mortality rates, though higher in whites compared to blacks (2.09:1.00) in Period I, are now comparable in Period II (0.90:1.00) but have reduced in both blacks and whites over the years. Similarly, in-hospital flexible sigmoidoscopy use has generally reduced over the years to similar levels for both blacks and whites. In-hospital colonoscopy rates have increased in blacks and reduced in whites from Period I to Period II. CONCLUSION: Our results suggest that discharge rates for CRC for blacks has increased and is similar in both whites and blacks probably as a result of equitable in-hospital use of diagnostic methods in the diagnosis/management of CRC.

Learning Objectives:

• "At the conclusion of this poster presentation, the participant (learner) in this session will be able to:
• 1. Identify the present trends among blacks and whites in the use of diagnostic procedures for colorectal cancer in hospitalized patients in the U.S.
• 2. Describe the differences in trends between blacks and whites for the use of colonoscopy and flexible sigmoidoscopy between blacks and whites.
• 3. Recognize the closing gap in access to care for colorectal cancer

Keywords: Equal Access, Ethnicity

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.