Abstract A155: Perceived interpersonal racism in healthcare settings and cancer screening
Authors: Star Jessica , Bandi Priti , Ashad-Bishop Kilan 
Published: September 2024

Abstract
Introduction: Black and Hispanic people frequently report that perceptions of their race or ethnicity underlie racist and discriminatory experiences in many settings. In the healthcare field, these interpersonal racist experiences can severely impact the decision to receive care and the general health of the patient. Previous studies assessing the role of perceived racial discrimination in the healthcare setting and cancer screenings struggled with low sample sizes that precluded meaningful conclusions. Also, a methodological issue not considered in prior studies is the large degree of uncertainty reported by racialized groups in their assessment of perceived racism and its relevance to the measurement of this construct. In response to these data limitations and newly available nationally representative Behavioral Risk Factor Surveillance System data, we assessed the relationship of perceived racial discrimination in the healthcare setting associated with timely cancer screening across racial/ethnic groups. Methods: Data was collected from the 2022 Behavioral Risk Factor Surveillance System, which is a nationally representative state level population-based household survey with 28 states and the District of Columbia administering the optional modules assessing perceived racial discrimination. Perceived racism in healthcare was measured with the question: “Within the past 12 months when seeking health care, do you feel your experiences were worse than, the same as, or better than for people of other races?”. The outcomes were USPSTF recommendation concordant up-to-date colorectal, cervical, and breast cancer screening. Survey weighted logistic regression models adjusted for age, sex, education, and state estimated prevalence differences stratified by race/ethnicity. Results: Colorectal, cervical, and breast cancer screening were lower in White persons who reported worse (aPD vs. "better": -11.6%, -15.8%, -19.3%) and uncertain (don’t know) experiences of racial discrimination (aPD vs. "better": -7.4%, -4.1%, -5.0%). Among Black people, colorectal and cervical screening were only lower in those reporting uncertain experiences (aPD vs. "better": -10.8% and -12.0%). Among Hispanic persons, breast cancer screening prevalence was lowest in those who reported uncertain and worse racial discrimination (aPD vs. “better”: -12.4% and -15.9%). Conclusions: In this large generalizable sample, perceived racial discrimination in the healthcare setting was associated with cancer screening for both White and Black persons, but in different ways. Worse interpersonal racism in the healthcare setting was associated with lower cancer screening in White persons; but being uncertain relative to other race groups was largely associated with worse cancer screening among Black persons. Uncertainty in self-reported, racist experiences must be considered in institutional efforts to measure and address racism in healthcare settings.
Citation Format: Jessica Star, Priti Bandi, Kilan Ashad-Bishop. Perceived interpersonal racism in healthcare settings and cancer screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A155.