Winning Abstracts from the 2009 Medical Student Abstract Competition: Race and Health Care Professional Recommendations for Colorectal Cancer Screening
Authors: Shayna E. Rich, MA; University of Maryland School of Medicine
Introduction:
Colorectal cancer screening rates are lower for African Americans
than Whites. It is not clear whether this difference is due to a
disparity in patient-health care professional interactions. This
study examined whether there is a racial difference in reporting a
recommendation for colorectal cancer screening from a health care
professional.
Methods:
A cross-sectional study was performed among 2,723 White and 657
African American Maryland residents age 50 years or older in the
2004 Maryland Cancer Survey, a population-based random digit dial
survey on cancer screening and risk behaviors. Respondents were
asked whether they had ever received a recommendation from a health
care professional for a sigmoidoscopy/colonoscopy or had received a
recommendation from a health care professional for a fecal occult
blood test (FOBT) in the preceding year, and about their colorectal
cancer screening history.
Results:
70% reported a recommendation for sigmoidoscopy/colonoscopy from a
health care professional (72% of Whites vs. 62% of African
Americans, p < 0.001). Among respondents who were not up-to-date
with colonoscopy, 34% reported a recommendation in the preceding
year for an FOBT. In multivariable analyses, the association
between race and health care professional recommendation for
sigmoidoscopy/colonoscopy varied by retirement status. The odds of
reporting a health care professional recommendation for
sigmoidoscopy/colonoscopy among non-retired Whites were
significantly greater than those of non-retired African Americans
(OR 1.56, 95% CI 1.20-2.03), while the odds among retired Whites
were 1.21 times those of retired African Americans but not
significantly different (95% CI 0.89-1.64). Reporting of
recommendations from health care professionals in the last year for
FOBT did not differ significantly between Whites and African
Americans among respondents who were not up-to-date with
colonoscopy (OR 0.99, 95% CI 0.75-1.30).
Conclusion:
White respondents were more likely than African Americans to report
ever having received a recommendation for sigmoidoscopy/colonoscopy
from a health care professional, especially for non-retired
respondents. No such difference existed for recommendation of FOBT
in the preceding year.