Race and colorectal cancer screening: a population-based study in North Carolina.
OBJECTIVE
National and state data document racial differences in colorectal cancer (CRC) mortality and incidence. Screening for CRC reduces cancer incidence and deaths. Racial differences in colorectal cancer screening behavior may contribute to the racial disparity in incidence and mortality. The purpose of this study was to determine if colorectal cancer screening rates are different between blacks and whites while controlling for potential confounders.


METHODS
Cross-sectional survey. DATA SOURCE(S)/STUDY SETTING: We used data from the North Carolina Colon Cancer Study, a population-based case-control study conducted in 33 counties of North Carolina. We analyzed data from 598 control subjects who were eligible for colorectal cancer screening.


METHODS
Trained nurses conducted face-to-face interviews from October 1996 through October 2000.


RESULTS
Overall, 50% of the respondents were compliant with CRC screening guidelines. In the multivariable logistic regression model having a regular doctor and participation in a general medical exam were significantly associated with current screening status with odds ratios (OR) (95% confidence interval (CI)) of 3.8 (1.7-8.3) and 3.7 (2.1-6.7), respectively. Older age was a significant predictor of current screening status with an OR (95% CI) of 2.9 (1.7-4.8) for those 60-69 compared to respondents 50-59 and OR 3.2 (1.9-5.5) for those 70 and older compared to respondents 50-59. After adjusting for age, having a regular doctor and participation in general medical exams, race was not significantly associated with current CRC screening status, with an OR of 1.1 (95% CI 0.7-1.6).


CONCLUSIONS
CRC screening rates in North Carolina were low. Race was not a significant determinant of screening behavior and therefore does not explain the racial disparity in incidence or survival. Older age, having a regular doctor and participating in general medical exams were significant predictors of CRC screening.


CONCLUSIONS
This study reinforces the fact that screening rates in North Carolina are low despite the strong evidence that colorectal cancer screening reduces cancer deaths.
Fisher
Deborah A
DA
Department of Medicine, Duke University Medical Center, Institute for Clinical and Epidemiological Research, Durham Veterans Affairs Medical Center, Durham, NC, USA. fishe034@mc.duke.edu
Dougherty
Karen
K
Martin
Christopher
C
Galanko
Joseph
J
Provenzale
Dawn
D
Sandler
Robert S
RS
D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American