title: Racial differences in use of colonoscopy, sigmoidoscopy, and barium enema in Medicare beneficiaries.
abstract: Colorectal cancer is often diagnosed at a later stage in blacks. We wanted to know if racial differences existed in the use of tests for detection of colorectal cancer. A 5% random sample was obtained of all Medicare beneficiaries with Part B coverage, aged 65 years and older and classified as white or black race. The numbers of colonoscopies, flexible sigmoidoscopies, and barium enemas were determined from the Physician/Supplier file. Blacks were 18% less likely to receive colonoscopy and 39% less likely to receive flexible sigmoidoscopy after controlling for age, sex, income, and access to care in a multivariable logistic regression model. Barium enema was not significantly different between the races. Black men had 25% lower use of colonoscopy and 50% decreased use of flexible sigmoidoscopy. Blacks receive less colonoscopy and flexible sigmoidoscopy than whites. Black men are particularly vulnerable to the under-use of these tests.
authors.affiliation: University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Richards
authors.forename: Dean M
authors.initials: DM
authors.lastname: Reker
mesh_terms: D001741:Black or African American; D000368:Aged; D001466:Barium Sulfate; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics; D004733:Enema / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D016345:Medicare Part B / Q000706:statistics & numerical data*; D012812:Sigmoidoscopy / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D044465:White People
chemical_list: D001466:Barium Sulfate