Racial and Ethnic Disparities in Colonoscopic Examination of Individuals With a Family History of Colorectal Cancer

被引:18
|
作者
Almario, Christopher V. [1 ,2 ]
May, Folasade P. [1 ,2 ]
Ponce, Ninez A. [3 ,4 ]
Spiegel, Brennan M. R. [1 ,3 ]
机构
[1] Cedars Sinai Ctr Outcomes Res & Educ CS CORE, Los Angeles, CA USA
[2] Univ Calif Los Angeles, Dept Med, Div Digest Dis, Los Angeles, CA 90024 USA
[3] UCLA Fielding Sch Publ Hlth, Dept Hlth Policy & Management, Los Angeles, CA USA
[4] UCLA Fielding Sch Publ Hlth, UCLA Ctr Hlth Policy Res, Los Angeles, CA USA
关键词
Colon Cancer; Prevention; Demographics; Detection; AFRICAN-AMERICANS; PHYSICIAN RECOMMENDATION; RISK; SURVEILLANCE; VALIDATION; PREDICTORS; GUIDELINES; KNOWLEDGE; BARRIERS; COLLEGE;
D O I
10.1016/j.cgh.2015.02.038
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND & AIMS: Guidelines recommend that persons with a high-risk family history of colorectal cancer (CRC) undergo colonoscopy examinations every 5 years, starting when they are 40 years old. We investigated factors associated with colonoscopy screening of individuals with a family history of CRC, focusing on race and ethnicity. METHODS: In a retrospective study, we analyzed data from the 2009 California Health Interview Survey on persons 40-80 years old with a first-degree relative (mother, father, sibling, or child) with CRC who had visited a physician within the past 5 years. Our study included an unweighted and population-weighted sample of 2539 and 870,214 individuals with a family history of CRC, respectively. We performed a survey-weighted logistic regression analysis to adjust for relevant demographic and socioeconomic variables and used estimates to calculate relative risks and 95% confidence intervals (CIs) for colonoscopy examination within the past 5 years. RESULTS: In the weighted sample, 60.0% of subjects received a colonoscopy within the past 5 years. A physician recommendation for CRC screening increased the odds that an individual would undergo colonoscopy examination (relative risk, 1.89; 95% CI, 1.61-2.24). Latinos were 31% less likely to receive colonoscopies than whites (95% CI, 7%-55%). Among individuals 40-49 years old, blacks were 71% less likely to have had a colonoscopy than whites (95% CI, 13%-96%). CONCLUSION: On the basis of an analysis of data from the California Health Interview Survey, less than two-thirds of individuals with a family history of CRC reported receiving guideline-recommended colonoscopy examinations within the past 5 years. We observed racial and ethnic disparities in colonoscopy screening of this high-risk group; Latinos and blacks were less likely to have had a colonoscopy than whites.
引用
收藏
页码:1487 / 1495
页数:9
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