Abstract C009: Colorectal cancer screening racial disparities among respondents who participated in 2016 CDC behavioral risk factor surveillance system
Authors: Song Jingwei , Tian Ligeng , Aliyu Muktar 
Published: August 2020

Background: Colorectal Cancer (CRC) almost always develops from precancerous polyps in the colon or rectum. Screening tests can find precancerous polyps for removal before they turn cancerous. The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer in adults using fecal occult blood test (FOBT) every year, sigmoidoscopy every 5 years, or colonoscopy every 10 years, from the age of 50 to 75. However, only about two thirds of people ages 50 to 75 have been screened for CRC, and racial disparities in colorectal cancer screening still exist.

Method: We performed logistic regression to determine CRC screening racial disparities by using 2016 CDC Behavioral Risk Factor Surveillance System (BRFSS) data.

Results: 190,000 respondents, ages 50 to 75, were used in logistic regression models. 9.0% of White non-Hispanic participants had FOBT within the last 12 months. Black non-Hispanic, Hispanic, other races non-Hispanic only, and Multiracial non-Hispanics are 11.8%, 12.2%, 12.3%, and 13.2%, respectively, to have had FOBT in the last 12 months. 69.0% of White non-Hispanic reported having a colonoscopy within the past 10 years. The percentage of those with a colonoscopy within the past 10 years for Black non-Hispanic, Hispanic, Other race non-Hispanic only, and Multiracial non-Hispanic is 66.6%, 54.0%, 56.4%, and 60.8%. 2.5% of all participants chose sigmoidoscopy within the past 5 years as CRC screening tool with no significant difference among race. 72.4% of White non-Hispanic fully met the USPSTF recommendation. 70.6%, 59.6%, 62.2%, and 67.3% of Black non-Hispanic, Hispanic, Other race non-Hispanic only, and Multiracial non-Hispanic, respectively, meet USPSTF recommendations. After adjusting for social economic status and other variables, compared to White non-Hispanics, Black non-Hispanics are still 20% more likely to choose FOBT as a CRC screening tool (OR = 0.800 and 95% CI 0.0.757,0.846). However, Black non-Hispanics were 17.3% more likely to have a colonoscopy as CRC screening tool and 20% more likely to meet USPSTF recommendations (OR =0.827 with 95% CI 0.793,0.862 and OR = 0.840 with 95% CI 0.804,0.846).

Conclusion: Compared to White non-Hispanics, Black non-Hispanics are more likely to choose FOBT and less like to choose colonoscopy as CRC screening tool. White non-Hispanics are significantly less likely to choose FOBT as CRC screening tool compared to others. However, colonoscopy as CRC screening between White non-Hispanics and Black non-Hispanics reveals no racial disparity. After adjusting for social economic status, Black non-Hispanics are more likely to choose colonoscopy and more likely to meet USPSTF screening recommendations compared to White non-Hispanic and other minorities. CRC screening between White non-Hispanic and Black non-Hispanic is driven by basic demographics, socioeconomic variables, access and self-rated health. However, CRC screening racial disparities between White non-Hispanics and other minorities still exist, especially among Hispanics.

Citation Format: Jingwei Song, Ligeng Tian, Muktar Aliyu. Colorectal cancer screening racial disparities among respondents who participated in 2016 CDC behavioral risk factor surveillance system [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C009.