196990 Trends in the racial disparity in healthcare professional recommendations for colorectal cancer screening

Tuesday, November 10, 2009: 2:55 PM

Shayna E. Rich, MA, MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Fatmatta Kuyateh, MD, MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Min Zhan, PhD , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Diane M. Dwyer, MD , Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Carmela Groves, RN, MS , Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Mary-Claire Roghmann, MD, MS , Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
Eileen K. Steinberger, MD, MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
  
Introduction

Colorectal cancer screening rates have increased over time, but screening rates remain lower for Blacks than Whites. It is not clear whether this difference is due to a disparity in patient-health care professional (HCP) interactions. This study examined whether there is a racial difference in reporting a recommendation for colorectal cancer screening from an HCP, and how this difference has changed over time.

Methods

Secondary analyses of data from 8,412 White and 1,785 Black Maryland residents age 50 years or older in the samples of the 2002, 2004, and 2006 Maryland Cancer Surveys, cross-sectional population-based random digit dial surveys on cancer screening and risk behaviors. Respondents were asked whether they had ever received an HCP recommendation for a sigmoidoscopy/colonoscopy.

Results

Overall, 71% of Whites and 61% of Blacks reported ever receiving an HCP recommendation for sigmoidoscopy/colonoscopy (p<0.001) For each race, reported recommendations for sigmoidoscopy/colonoscopy increased significantly over time (66%-75% for Whites and 56%-66% for Blacks; p<0.001 for both), but the race disparity remained ~10% at each survey year. In multivariable analyses, the odds of reporting a recommendation among Whites were 1.5 times that of Blacks (95% CI 1.3-1.7). The effect of race on the odds of reporting an HCP recommendation for sigmoidoscopy/colonoscopy did not vary significantly across time (p=0.52).

Conclusion

Whites were more likely than Blacks to report ever having received a recommendation for sigmoidoscopy/colonoscopy from an HCP. Although the proportion of patients receiving recommendations for sigmoidoscopy/colonoscopy is increasing over time, the gap between races has not changed significantly.

Learning Objectives:
To analyze and compare the trends in health care provider recommendations for colorectal cancer screening between 2002 and 2006, by race.

Keywords: Health Disparities, Cancer Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted the analysis and prepared the manuscript for the research I will be presenting.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Cancer Screening and Prevention
See more of: Epidemiology