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
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.
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.
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).
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.