Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems

Andrea N. Burnett-Hartman, Shivan J. Mehta, Yingye Zheng, Nirupa R. Ghai, Dale F. McLerran, Jessica Chubak, Virginia P. Quinn, Celette Sugg Skinner, Douglas A. Corley, John M. Inadomi, Chyke A. Doubeni

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Introduction: Racial/ethnic disparities in colorectal cancer (CRC) screening and diagnostic testing present challenges to CRC prevention programs. Thus, it is important to understand how differences in CRC screening approaches between healthcare systems are associated with racial/ethnic disparities. Methods: This was a retrospective cohort study of patients aged 50-75 years who were members of the Population-based Research Optimizing Screening Through Personalized Regimens cohort from 2010 to 2012. Data on race/ethnicity, CRC screening, and diagnostic testing came from medical records. Data collection occurred in 2014 and analysis in 2015. Logistic regression models were used to calculate AORs and 95% CIs comparing completion of CRC screening between racial/ethnic groups. Analyses were stratified by healthcare system to assess differences between systems. Results: There were 1,746,714 participants across four healthcare systems. Compared with non-Hispanic whites (whites), odds of completing CRC screening were lower for non-Hispanic blacks (blacks) in healthcare systems with high screening rates (AOR=0.86, 95% CI=0.84, 0.88) but similar between blacks and whites in systems with lower screening rates (AOR=1.01, 95% CI=0.93, 1.09). Compared with whites, American Indian/Alaskan Natives had lower odds of completing CRC screening across all healthcare systems (AOR=0.76, 95% CI=0.72, 0.81). Hispanics had similar odds of CRC screening (AOR=0.99, 95% CI=0.98, 1.00) and Asian/Pacific Islanders had higher odds of CRC screening (AOR=1.16, 95% CI=1.15, 1.18) versus whites. Conclusions: Racial/ethnic differences in CRC screening vary across healthcare systems, particularly for blacks, and may be more pronounced in systems with intensive CRC screening approaches.

Original languageEnglish (US)
JournalAmerican Journal of Preventive Medicine
DOIs
StateAccepted/In press - 2016

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Early Detection of Cancer
Colorectal Neoplasms
Delivery of Health Care
Logistic Models
North American Indians
Population Groups
Hispanic Americans
Ethnic Groups
Medical Records
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Burnett-Hartman, A. N., Mehta, S. J., Zheng, Y., Ghai, N. R., McLerran, D. F., Chubak, J., ... Doubeni, C. A. (Accepted/In press). Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2016.02.025

Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems. / Burnett-Hartman, Andrea N.; Mehta, Shivan J.; Zheng, Yingye; Ghai, Nirupa R.; McLerran, Dale F.; Chubak, Jessica; Quinn, Virginia P.; Skinner, Celette Sugg; Corley, Douglas A.; Inadomi, John M.; Doubeni, Chyke A.

In: American Journal of Preventive Medicine, 2016.

Research output: Contribution to journalArticle

Burnett-Hartman, AN, Mehta, SJ, Zheng, Y, Ghai, NR, McLerran, DF, Chubak, J, Quinn, VP, Skinner, CS, Corley, DA, Inadomi, JM & Doubeni, CA 2016, 'Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems', American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2016.02.025
Burnett-Hartman, Andrea N. ; Mehta, Shivan J. ; Zheng, Yingye ; Ghai, Nirupa R. ; McLerran, Dale F. ; Chubak, Jessica ; Quinn, Virginia P. ; Skinner, Celette Sugg ; Corley, Douglas A. ; Inadomi, John M. ; Doubeni, Chyke A. / Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems. In: American Journal of Preventive Medicine. 2016.
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title = "Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems",
abstract = "Introduction: Racial/ethnic disparities in colorectal cancer (CRC) screening and diagnostic testing present challenges to CRC prevention programs. Thus, it is important to understand how differences in CRC screening approaches between healthcare systems are associated with racial/ethnic disparities. Methods: This was a retrospective cohort study of patients aged 50-75 years who were members of the Population-based Research Optimizing Screening Through Personalized Regimens cohort from 2010 to 2012. Data on race/ethnicity, CRC screening, and diagnostic testing came from medical records. Data collection occurred in 2014 and analysis in 2015. Logistic regression models were used to calculate AORs and 95{\%} CIs comparing completion of CRC screening between racial/ethnic groups. Analyses were stratified by healthcare system to assess differences between systems. Results: There were 1,746,714 participants across four healthcare systems. Compared with non-Hispanic whites (whites), odds of completing CRC screening were lower for non-Hispanic blacks (blacks) in healthcare systems with high screening rates (AOR=0.86, 95{\%} CI=0.84, 0.88) but similar between blacks and whites in systems with lower screening rates (AOR=1.01, 95{\%} CI=0.93, 1.09). Compared with whites, American Indian/Alaskan Natives had lower odds of completing CRC screening across all healthcare systems (AOR=0.76, 95{\%} CI=0.72, 0.81). Hispanics had similar odds of CRC screening (AOR=0.99, 95{\%} CI=0.98, 1.00) and Asian/Pacific Islanders had higher odds of CRC screening (AOR=1.16, 95{\%} CI=1.15, 1.18) versus whites. Conclusions: Racial/ethnic differences in CRC screening vary across healthcare systems, particularly for blacks, and may be more pronounced in systems with intensive CRC screening approaches.",
author = "Burnett-Hartman, {Andrea N.} and Mehta, {Shivan J.} and Yingye Zheng and Ghai, {Nirupa R.} and McLerran, {Dale F.} and Jessica Chubak and Quinn, {Virginia P.} and Skinner, {Celette Sugg} and Corley, {Douglas A.} and Inadomi, {John M.} and Doubeni, {Chyke A.}",
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T1 - Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems

AU - Burnett-Hartman, Andrea N.

AU - Mehta, Shivan J.

AU - Zheng, Yingye

AU - Ghai, Nirupa R.

AU - McLerran, Dale F.

AU - Chubak, Jessica

AU - Quinn, Virginia P.

AU - Skinner, Celette Sugg

AU - Corley, Douglas A.

AU - Inadomi, John M.

AU - Doubeni, Chyke A.

PY - 2016

Y1 - 2016

N2 - Introduction: Racial/ethnic disparities in colorectal cancer (CRC) screening and diagnostic testing present challenges to CRC prevention programs. Thus, it is important to understand how differences in CRC screening approaches between healthcare systems are associated with racial/ethnic disparities. Methods: This was a retrospective cohort study of patients aged 50-75 years who were members of the Population-based Research Optimizing Screening Through Personalized Regimens cohort from 2010 to 2012. Data on race/ethnicity, CRC screening, and diagnostic testing came from medical records. Data collection occurred in 2014 and analysis in 2015. Logistic regression models were used to calculate AORs and 95% CIs comparing completion of CRC screening between racial/ethnic groups. Analyses were stratified by healthcare system to assess differences between systems. Results: There were 1,746,714 participants across four healthcare systems. Compared with non-Hispanic whites (whites), odds of completing CRC screening were lower for non-Hispanic blacks (blacks) in healthcare systems with high screening rates (AOR=0.86, 95% CI=0.84, 0.88) but similar between blacks and whites in systems with lower screening rates (AOR=1.01, 95% CI=0.93, 1.09). Compared with whites, American Indian/Alaskan Natives had lower odds of completing CRC screening across all healthcare systems (AOR=0.76, 95% CI=0.72, 0.81). Hispanics had similar odds of CRC screening (AOR=0.99, 95% CI=0.98, 1.00) and Asian/Pacific Islanders had higher odds of CRC screening (AOR=1.16, 95% CI=1.15, 1.18) versus whites. Conclusions: Racial/ethnic differences in CRC screening vary across healthcare systems, particularly for blacks, and may be more pronounced in systems with intensive CRC screening approaches.

AB - Introduction: Racial/ethnic disparities in colorectal cancer (CRC) screening and diagnostic testing present challenges to CRC prevention programs. Thus, it is important to understand how differences in CRC screening approaches between healthcare systems are associated with racial/ethnic disparities. Methods: This was a retrospective cohort study of patients aged 50-75 years who were members of the Population-based Research Optimizing Screening Through Personalized Regimens cohort from 2010 to 2012. Data on race/ethnicity, CRC screening, and diagnostic testing came from medical records. Data collection occurred in 2014 and analysis in 2015. Logistic regression models were used to calculate AORs and 95% CIs comparing completion of CRC screening between racial/ethnic groups. Analyses were stratified by healthcare system to assess differences between systems. Results: There were 1,746,714 participants across four healthcare systems. Compared with non-Hispanic whites (whites), odds of completing CRC screening were lower for non-Hispanic blacks (blacks) in healthcare systems with high screening rates (AOR=0.86, 95% CI=0.84, 0.88) but similar between blacks and whites in systems with lower screening rates (AOR=1.01, 95% CI=0.93, 1.09). Compared with whites, American Indian/Alaskan Natives had lower odds of completing CRC screening across all healthcare systems (AOR=0.76, 95% CI=0.72, 0.81). Hispanics had similar odds of CRC screening (AOR=0.99, 95% CI=0.98, 1.00) and Asian/Pacific Islanders had higher odds of CRC screening (AOR=1.16, 95% CI=1.15, 1.18) versus whites. Conclusions: Racial/ethnic differences in CRC screening vary across healthcare systems, particularly for blacks, and may be more pronounced in systems with intensive CRC screening approaches.

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