Colorectal Cancer Screening and Race in an Equal Access Medical System

Abstract

National colorectal cancer (CRC) screening rates have improved, but significant racial disparities have been identified. Improved access to care has been proposed as a solution to eliminate such disparities. To determine if racial disparities in CRC screening rates persist in a medical system without barriers to access or cost. A retrospective review study was performed, examining the healthcare effectiveness data and information set data from patients between the ages of 50 and 65 years who were eligible for CRC screening. Data on the type of CRC screening and rates of up-to-date screening were also examined. Data were available for 14,196 patients of whom 8809 (62 %) reported race. Subjects included were 53 % male and 47 % female, with breakdown by race as follows: 53 % White, 34 % Asian/Pacific Islander, 11 % Black, 1 % Hispanic, and <1 % Native-American. Overall, CRC screening and up-to-date rates were higher than the national average (81 and 72 %, respectively). Blacks were less likely than non-Blacks to have undergone CRC screening (75 vs. 82 %, p < 0.001), and were also less likely to be up-to-date with CRC screening (66 vs. 72 %, p < 0.001). Despite elimination of access and cost barriers, racial disparities in CRC screening persist. Equal access to CRC screening tools will be necessary, but not sufficient, to eliminate the currently observed national trends. Further study should focus on elucidating patient-specific barriers to successful completion and maintenance of CRC screening.