Latinos, Blacks with family history of CRC less likely to receive colonoscopy than whites

As seen in Healio Gastroenterology

Almario CV, et al. Clin Gastroenterol Hepatol. 2015;doi:10.1016/j.cgh.2015.02.038.

Among individuals with a family history of colorectal cancer, Latinos and blacks were less likely to undergo guideline-recommended screening colonoscopy compared with whites, according to recent study data.

“It has been well established that there are racial and ethnic disparities in colorectal cancer screening among those at average risk for the disease,”Christopher V. Almario, MD, MSHPM, from Cedars-Sinai Medical Center, told Healio Gastroenterology. “However, it is not as clear whether these same disparities exist among individuals with a family history of colorectal cancer – a group that is at very high risk for also developing cancer and has the most to benefit from colonoscopy screening.”

To examine associations between race/ethnicity and screening colonoscopy among individuals with a family history of CRC, Almario, Brennan M. R. Spiegel, MD, MSHS, from Cedars-Sinai and UCLA Fielding School of Public Health in Los Angeles, and colleagues performed a survey-weighted logistic regression model using data from the 2009 California Health Interview Survey.

They identified an unweighted sample of 2,539 individuals and a population-weighted sample of 870,214 individuals aged 40 to 80 years who had visited a doctor within the past 5 years and had a first-degree relative with CRC. The primary outcome measure was colonoscopy within the past 5 years based on guideline recommendations.

Overall, 60% of the weighted sample reported receiving colonoscopy within the past 5 years, with the highest rates attributed to whites (64.5%) and Asians (68.1%) compared with Latinos (33.2%), blacks (49.5%) and “other” (50.1%;P < .001). Individuals who reported having received a physician recommendation for CRC screening were 89% (95% CI, 61%-124%) more likely to have received a colonoscopy within the past 5 years, but rates of physician recommendation differed significantly between racial/ethnic groups (P < .001).

Subgroup analysis of individuals aged 40 to 49 years showed the differences in rates of physician recommendation for CRC screening persisted (P = .04), and blacks in this age group were 71% (95% CI, 13%-96%) less likely to have undergone colonoscopy compared with whites.

“In our study we found that less than two-thirds of Californians with a family history of colorectal cancer had a guideline-recommended colonoscopy in the last 5 years,” Almario said. “We also found continued evidence of disparities, as Latinos and African-Americans were less likely to be screened compared to whites. These findings call attention to the need for targeted, tailored interventions to address these disparities and to increase colonoscopy screening among these high-risk groups.” – by Adam Leitenberger

Disclosure: The researchers report no relevant financial disclosures.