Racial and Ethnic Disparities in Colonoscopic Examination of Individuals With a Family History of Colorectal Cancer.
OBJECTIVE
Guidelines recommend that persons with a high-risk family history of colorectal cancer (CRC) undergo colonoscopy examinations every 5 years, starting when they are 40 years old. We investigated factors associated with colonoscopy screening of individuals with a family history of CRC, focusing on race and ethnicity.


METHODS
In a retrospective study, we analyzed data from the 2009 California Health Interview Survey on persons 40-80 years old with a first-degree relative (mother, father, sibling, or child) with CRC who had visited a physician within the past 5 years. Our study included an unweighted and population-weighted sample of 2539 and 870,214 individuals with a family history of CRC, respectively. We performed a survey-weighted logistic regression analysis to adjust for relevant demographic and socioeconomic variables and used estimates to calculate relative risks and 95% confidence intervals (CIs) for colonoscopy examination within the past 5 years.


RESULTS
In the weighted sample, 60.0% of subjects received a colonoscopy within the past 5 years. A physician recommendation for CRC screening increased the odds that an individual would undergo colonoscopy examination (relative risk, 1.89; 95% CI, 1.61-2.24). Latinos were 31% less likely to receive colonoscopies than whites (95% CI, 7%-55%). Among individuals 40-49 years old, blacks were 71% less likely to have had a colonoscopy than whites (95% CI, 13%-96%).


CONCLUSIONS
On the basis of an analysis of data from the California Health Interview Survey, less than two-thirds of individuals with a family history of CRC reported receiving guideline-recommended colonoscopy examinations within the past 5 years. We observed racial and ethnic disparities in colonoscopy screening of this high-risk group; Latinos and blacks were less likely to have had a colonoscopy than whites.
Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California; Division of Digestive Diseases, Department of Medicine, UCLA, Los Angeles, California.
Christopher V
CV
Almario
Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California; Division of Digestive Diseases, Department of Medicine, UCLA, Los Angeles, California.
Folasade P
FP
May
Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California; UCLA Center for Health Policy Research, UCLA Fielding School of Public Health, Los Angeles, California.
Ninez A
NA
Ponce
Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California. Electronic address: Brennan.Spiegel@cshs.org.
Brennan M R
BM
Spiegel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003710:Demography; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D012959:Socioeconomic Factors
Colon Cancer; Demographics; Detection; Prevention