Low screening rates linked with less availability of endoscopy in Hispanic communities
MONDAY, April 12 (HealthDay News) -- Hispanics are more likely than African-Americans or whites to live in areas where there is more limited availability of endoscopy, which may explain disparities in colorectal cancer (CRC) screening rates and stage at diagnosis, according to research published online April 12 in Cancer.
Jennifer S. Haas, M.D., of Brigham and Women's Hospital in Boston, and colleagues examined data on CRC screening from the National Health Interview Survey and data on CRC stage from the Surveillance, Epidemiology, and End Results program and Medicare. They used Medicare claims to determine a county's capacity for colonoscopy and sigmoidoscopy (endoscopy).
They found that Hispanics live in counties with less capacity for endoscopy than African-Americans or whites, with 1,124, 1,569, and 1,628 procedures performed per 100,000 individuals aged 50 and over, respectively. Use of CRC screening improved modestly with increased county capacity; as the number of endoscopies per 100,000 residents climbed by 750, the odds of being screened improved by 4 percent. Screening disparities were mitigated or diminished after adjustment for racial/ethnic composition, endoscopy capacity, and socioeconomic status. Also, individuals with CRC who lived in low-capacity counties were marginally less likely to be diagnosed at an early stage.
"Increasing the use of CRC screening may require interventions to improve capacity for endoscopy in some areas. The characteristics of the area where an individual resides may in part mediate disparities in CRC screening use for both African-Americans and Hispanics, and disparities in cancer stage for Hispanics," the authors write.
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