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Colorectal Cancer Screening Initiation After Age 50 Years in an Organized Program.
- Source :
-
American journal of preventive medicine [Am J Prev Med] 2017 Sep; Vol. 53 (3), pp. 335-344. Date of Electronic Publication: 2017 Apr 17. - Publication Year :
- 2017
-
Abstract
- Introduction: Recent studies report racial disparities among individuals in organized colorectal cancer (CRC) programs; however, there is a paucity of information on CRC screening utilization by race/ethnicity among newly age-eligible adults in such programs.<br />Methods: This was a retrospective cohort study among Kaiser Permanente Northern California enrollees who turned age 50 years between 2007 and 2012 (N=138,799) and were served by a systemwide outreach and facilitated in-reach screening program based primarily on mailed fecal immunochemical tests to screening-eligible people. Kaplan-Meier and Cox model analyses were used to estimate differences in receipt of CRC screening in 2015-2016.<br />Results: Cumulative probabilities of CRC screening within 1 and 2 years of subjects' 50th birthday were 51% and 73%, respectively. Relative to non-Hispanic whites, the likelihood of completing any CRC screening was similar in blacks (hazard ratio, 0.98; 95% CI=0.96, 1.00); 5% lower in Hispanics (hazard ratio, 0.95; 95% CI=0.93, 0.96); and 13% higher in Asians (hazard ratio, 1.13; 95% CI=1.11, 1.15) in adjusted analyses. Fecal immunochemical testing was the most common screening modality, representing 86% of all screening initiations. Blacks and Hispanics had lower receipt of fecal immunochemical testing in adjusted analyses.<br />Conclusions: CRC screening uptake was high among newly screening-eligible adults in an organized CRC screening program, but Hispanics were less likely to initiate screening near age 50 years than non-Hispanic whites, suggesting that cultural and other individual-level barriers not addressed within the program likely contribute. Future studies examining the influences of culturally appropriate and targeted efforts for screening initiation are needed.<br /> (Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- California
Early Detection of Cancer methods
Ethnicity statistics & numerical data
Female
Humans
Male
Mass Screening methods
Middle Aged
Occult Blood
Racial Groups statistics & numerical data
Retrospective Studies
Colorectal Neoplasms diagnosis
Early Detection of Cancer statistics & numerical data
Healthcare Disparities statistics & numerical data
Mass Screening statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2607
- Volume :
- 53
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- American journal of preventive medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28427954
- Full Text :
- https://doi.org/10.1016/j.amepre.2017.02.018