title: Trends in self-reported health care provider recommendations for colorectal cancer screening by race.
abstract: OBJECTIVE
  To examine whether a racial difference exists in self-reported recommendations for colorectal cancer screening from a health care provider, and whether this difference has changed over time.
  
  
  METHODS
  Secondary analysis of the 2002, 2004, 2006, and 2008 Maryland Cancer Surveys, cross-sectional population-based random-digit-dial surveys on cancer screening. Participants were 11,368 White and 2495 Black Maryland residents age ≥ 50 years.
  
  
  RESULTS
  For each race, recommendations for colonoscopy/sigmoidoscopy increased over time (67%-83% for Whites, 57%-74% for Blacks; p<0.001 for both), but the race difference remained approximately 10% at each survey. Among respondents without a colonoscopy in the last 10 years (n=5081), recommendations for fecal occult blood test (FOBT) in the past year decreased over time for Whites (37%-24%, p<0.001) and for Blacks (36-28%, p=0.05), with no difference by race in any year. In multivariable analysis, the effect of race on the odds of reporting a provider recommendation did not vary significantly across time for either test (p=0.80 for colonoscopy/sigmoidoscopy, p=0.24 for FOBT for effect modification by year).
  
  
  CONCLUSIONS
  Whites were more likely than Blacks to report ever receiving a provider recommendation for colonoscopy/sigmoidoscopy. Although the proportion of patients receiving recommendations for colonoscopy/sigmoidoscopy increased over time, the gap between races remained unchanged.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood Street, Baltimore, MD 21201, USA. shayna.rich@gmail.com
authors.forename: Shayna E
authors.initials: SE
authors.lastname: Rich
authors.forename: Fatmatta M
authors.initials: FM
authors.lastname: Kuyateh
authors.forename: Diane M
authors.initials: DM
authors.lastname: Dwyer
authors.forename: Carmela
authors.initials: C
authors.lastname: Groves
authors.forename: Eileen K
authors.initials: EK
authors.lastname: Steinberger
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005243:Feces / Q000166:cytology; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008396:Maryland; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D044465:White People / Q000706:statistics & numerical data*