Colorectal cancer screening in African Americans: are we following the guidelines?

Purpose The age at onset, incidence, and mortality rate of colorectal cancer varies among racial groups being highest in African Americans. This increased risk led to the recommendation to begin screening at the age of 45 years. Whether the recommendation for screening of African Americans at an ear...

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Bibliographic Details
Published in:Cancer causes & control 2021-09, Vol.32 (9), p.943-951
Main Authors: Millien, Valentine Ongeri, Levine, Phillip, Suarez, Milena Gould
Format: Article
Language:English
Subjects:
African Americans
Age
Biomedical and Life Sciences
Biomedicine
Cancer
Cancer Research
Cancer screening
Colorectal cancer
Colorectal carcinoma
Computed tomography
Epidemiology
Health policy
Hematology
Heme
Medical screening
Minority & ethnic groups
Oncology
Original Paper
Public Health
Sigmoidoscopy
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Summary:Purpose The age at onset, incidence, and mortality rate of colorectal cancer varies among racial groups being highest in African Americans. This increased risk led to the recommendation to begin screening at the age of 45 years. Whether the recommendation for screening of African Americans at an earlier age was implemented is unknown. Methods We used data from the Cancer Control Supplement of National Health Interview Survey (NHIS) conducted in the years 2005, 2010, and 2015 to analyze demographic data and use of colorectal screening (colonoscopy, stool heme testing, sigmoidoscopy, computed tomographic colonography) among the US population between the ages of 45–49 years. Results Data on colorectal screening was available from 6740 individuals; 16.5% were African Americans. Screening test use among African Americans in 2005, 2010, and 2015 was similar to use in Whites (i.e., 15.4% (95% CI 11.4–19.4), 28.4% (95% CI 19.3–30.4) and 20.2% (95% CI 14.8–25.5) vs. 16.9% (95% CI 15.1–18.6), 19.3% (95% CI 16.9–21.7), and 21.4% (95% CI 18.6–24.2) in 2005, 2010 and 2015, respectively. Observed screening test use rates may largely be accounted for by diagnostic exams. Conclusion The recommendation for earlier colorectal screening of African Americans has not yet resulted in increased test utilization. These results emphasize the need for multidisciplinary actions to inform and implement public health policy.
ISSN:0957-5243
1573-7225
DOI:10.1007/s10552-021-01448-8