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Study evaluates Racial Disparities in Colon
Cancer Screening
Newswise — Blacks and Hispanics appear less
likely to undergo colorectal cancer
screening than whites because of
socioeconomic, health care access and
language barriers, according to a report in
the June 23 issue of Archives of Internal
Medicine, one of the JAMA/Archives
journals.
However, other factors may contribute to
screening disparities experienced by Asians.
Colorectal cancer screening rates lag behind
those for other cancer screening tests,
according to background information in the
article.
In addition, marked disparities appear to
exist between non-Hispanic whites and racial
and ethnic minorities in the United States.
“Such disparities in screening may
contribute to the higher colorectal cancer
incidence and mortality [death] rates
observed in racial/ethnic minorities
relative to non-Hispanic whites,” the
authors write.
Anthony F. Jerant, M.D., and colleagues at
the University of California Davis School of
Medicine, Sacramento, analyzed data from two
national surveys conducted between 2000 and
2005.
A total of 22,973 adults age 50 and older
answered questions about demographics,
colorectal cancer screening behaviors and
other social and health care factors.
Overall, 54.1 percent of the participants
were screened for colorectal cancer using
either colonoscopy or fecal occult blood
testing (FOBT).
Individuals in racial and ethnic minority
groups were less likely than whites to be
tested—33.8 percent of Asians, 48.2 percent
of blacks and 36.7 percent of Hispanics
underwent a screening procedure, compared
with 57.2 percent of whites.
After adjusting for other factors associated
with screening behavior—including
demographics, socioeconomic variables,
language spoken at home, health care access
and self-rated health—disparities between
blacks, Hispanics and whites disappeared,
the authors note.
“Beyond socioeconomic factors, which
disproportionately affect minorities, these
findings suggest the effect of access and,
for Hispanics, language-appropriate care on
colorectal cancer screening uptake,” they
write.
However, after adjusting for the same
factors, disparities between whites and
Asians remained significant.
“Although
this study does not permit firm conclusions
regarding the reason for this finding, the
implication is that unmeasured cultural
factors may contribute to the
Asian/non-Hispanic white disparity in
colorectal cancer screening,” the authors
write.
“Less acculturated Asian individuals in the
United States may have core health beliefs
and values that differ from those in the
‘Western’ health model, leading them to
decline FOBT or endoscopy offered in the
absence of worrisome symptoms. They may also
be less likely to be offered colorectal
cancer screening.”
The findings suggest that different types of
programs may improve screening rates in
separate minority groups, the authors
conclude.
Culturally targeted interventions for
patients and physicians may help address
Asian individuals, enhancing access to
health care may help mitigate disparities
between white and black patients and
maximizing access and offering
language-appropriate care and information
may increase the number of Hispanics who are
screened.
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