title: United States colorectal cancer screening practices among American Indians/Alaska Natives, blacks, and non-Hispanic whites in the new millennium (2001 to 2010).
abstract: BACKGROUND
  The objectives of this study were to describe, examine, and compare prevalence estimates of colorectal cancer (CRC) screening practices and to determine whether disparities exist for American Indians/Alaska Natives (AIANs) and blacks compared with whites.
  
  
  METHODS
  Behavioral Risk Factor Surveillance System (2001-2010) data from respondents aged ≥ 50 years (n = 356,073) were used. The primary outcome was self-reported CRC screening according to US Preventive Services Task Force guidelines for endoscopy (colonoscopy or sigmoidoscopy), fecal occult blood test (FOBT), or mixed screening (endoscopy or FOBT).
  
  
  RESULTS
  From 2001 to 2010, endoscopy screening increased in the AIAN population by 44.8% (P < .001) compared with black respondents (51.7%) and white respondents (26.5%). AIANs were less likely to report endoscopy screening (45%) compared with both blacks (56%) and whites (55%). For mixed CRC screenings, AIAN rates increased by 34.5%, compared with 29.7% for blacks and 15% for whites. In 2010, AIANs (51%) had the lowest prevalence of mixed CRC screening compared with blacks (61%) and whites (60%; P < .001). Factors that enabled health care attenuated the lowered likelihood of CRC screenings, but disparities remained for AIAN CRC screening. In contrast, once enabling factors were controlled, the odds ratios of CRC screening among blacks were higher compared with whites.
  
  
  CONCLUSIONS
  Between 2001 and 2010, AIANs had the lowest CRC screening rates in the United States compared with blacks and whites, presenting a CRC disparity, as rigorously defined. The current findings indicate that, although considerable progress has been made to increase CRC screening for blacks and whites, progress for AIANs continues to lag behind in the first decade of 21st century.
authors.affiliation: Research for Indigenous Community Health (RICH) Center, College of Pharmacy, Pharmacy Practice, and Pharmaceutical Sciences/Social and Administrative Pharmacy, University of Minnesota, Duluth, Minnesota.
authors.forename: Michelle Dawn
authors.initials: MD
authors.lastname: Johnson-Jennings
authors.forename: Wassim
authors.initials: W
authors.lastname: Tarraf
authors.forename: Kyle
authors.initials: K
authors.lastname: Xavier Hill
authors.forename: Hector M
authors.initials: HM
authors.lastname: González
mesh_terms: D044383:Black People / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
keywords: African American; American Indian; black; colorectal cancer; health disparities