Show simple item record

dc.contributor.authorLaiyemo, Adeyinka O.
dc.contributor.authorDoubeni, Chyke A.
dc.contributor.authorPinsky, Paul F.
dc.contributor.authorDoria-Rose, V. Paul
dc.contributor.authorBresalier, Robert
dc.contributor.authorLamerato, Lois E.
dc.contributor.authorCrawford, E. David
dc.contributor.authorKvale, Paul
dc.contributor.authorFouad, Mona N.
dc.contributor.authorHickey, Thomas
dc.contributor.authorRiley, Thomas
dc.contributor.authorWeissfeld, Joel
dc.contributor.authorSchoen, Robert E.
dc.contributor.authorMarcus, Pamela M.
dc.contributor.authorProrok, Philip C.
dc.contributor.authorBerg, Christine D.
dc.date2022-08-11T08:09:23.000
dc.date.accessioned2022-08-23T16:28:43Z
dc.date.available2022-08-23T16:28:43Z
dc.date.issued2010-04-21
dc.date.submitted2011-12-30
dc.identifier.citationJ Natl Cancer Inst. 2010 Apr 21;102(8):538-46. Epub 2010 Mar 31. <a href="http://dx.doi.org/10.1093/jnci/djq068">Link to article on publisher's site</a>
dc.identifier.issn0027-8874 (Linking)
dc.identifier.doi10.1093/jnci/djq068
dc.identifier.pmid20357245
dc.identifier.urihttp://hdl.handle.net/20.500.14038/37082
dc.description.abstractBACKGROUND: It is unclear whether the disproportionately higher incidence and mortality from colorectal cancer among blacks compared with whites reflect differences in health-care utilization or colorectal cancer susceptibility. METHODS: A total of 60, 572 non-Hispanic white and black participants in the ongoing Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial underwent trial-sponsored screening flexible sigmoidoscopy (FSG) without biopsy at baseline in 10 geographically dispersed centers from November 1993 to July 2001. Subjects with polyps or mass lesions detected by FSG were referred to their physicians for diagnostic workup, the cost of which was not covered by PLCO. The records of follow-up evaluations were collected and reviewed. We used log binomial modeling with adjustment for age, education, sex, body mass index, smoking, family history of colorectal cancer, colon examination within previous 3 years, personal history of polyps, and screening center to examine whether utilization of diagnostic colonoscopy and yield of neoplasia differed by race. RESULTS: Among 57 561 whites and 3011 blacks who underwent FSG, 13,743 (23.9%) and 767 (25.5%) had abnormal examinations, respectively. A total of 9944 (72.4%) whites and 480 (62.6%) blacks had diagnostic colonoscopy within 1 year following the abnormal FSG screening. When compared with whites, blacks were less likely to undergo diagnostic evaluation (adjusted risk ratio = 0.88, 95% confidence interval = 0.83 to 0.93). Overall, among subjects with diagnostic colonoscopy (n = 10 424), there was no statistically significant difference by race in the prevalence of adenoma, advanced adenoma, advanced pathology in small adenomas (high-grade dysplasia or villous histology in adenomas <10 >mm), or colorectal cancer. CONCLUSIONS: We observed a lower follow-up for screen-detected abnormalities among blacks when compared with whites but little difference in the yield of colorectal neoplasia. Health-care utilization may be playing more of a role in colorectal cancer racial disparity than biology.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20357245&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857802/pdf/djq068.pdf
dc.subjectAfrican Americans
dc.subjectAged
dc.subjectColonoscopy
dc.subjectColorectal
dc.subjectNeoplasms
dc.subjectDelivery of Health Care
dc.subjectEarly Detection of Cancer
dc.subjectEuropean Continental Ancestry Group
dc.subjectFemale
dc.subjectGenetic Predisposition to Disease
dc.subjectHealthcare Disparities
dc.subjectHumans
dc.subjectIncidence
dc.subjectLung Neoplasms
dc.subjectMale
dc.subjectMass Screening
dc.subjectMiddle Aged
dc.subjectOvarian Neoplasms
dc.subjectProstatic Neoplasms
dc.subjectRandomized Controlled Trials as Topic
dc.subjectRisk Factors
dc.subjectSigmoidoscopy
dc.subjectSocioeconomic Factors
dc.subjectUnited States
dc.subjectHealth Services Research
dc.subjectPrimary Care
dc.titleRace and colorectal cancer disparities: health-care utilization vs different cancer susceptibilities
dc.typeJournal Article
dc.source.journaltitleJournal of the National Cancer Institute
dc.source.volume102
dc.source.issue8
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/meyers_pp/464
dc.identifier.contextkey2426121
html.description.abstract<p>BACKGROUND: It is unclear whether the disproportionately higher incidence and mortality from colorectal cancer among blacks compared with whites reflect differences in health-care utilization or colorectal cancer susceptibility.</p> <p>METHODS: A total of 60, 572 non-Hispanic white and black participants in the ongoing Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial underwent trial-sponsored screening flexible sigmoidoscopy (FSG) without biopsy at baseline in 10 geographically dispersed centers from November 1993 to July 2001. Subjects with polyps or mass lesions detected by FSG were referred to their physicians for diagnostic workup, the cost of which was not covered by PLCO. The records of follow-up evaluations were collected and reviewed. We used log binomial modeling with adjustment for age, education, sex, body mass index, smoking, family history of colorectal cancer, colon examination within previous 3 years, personal history of polyps, and screening center to examine whether utilization of diagnostic colonoscopy and yield of neoplasia differed by race.</p> <p>RESULTS: Among 57 561 whites and 3011 blacks who underwent FSG, 13,743 (23.9%) and 767 (25.5%) had abnormal examinations, respectively. A total of 9944 (72.4%) whites and 480 (62.6%) blacks had diagnostic colonoscopy within 1 year following the abnormal FSG screening. When compared with whites, blacks were less likely to undergo diagnostic evaluation (adjusted risk ratio = 0.88, 95% confidence interval = 0.83 to 0.93). Overall, among subjects with diagnostic colonoscopy (n = 10 424), there was no statistically significant difference by race in the prevalence of adenoma, advanced adenoma, advanced pathology in small adenomas (high-grade dysplasia or villous histology in adenomas <10 >mm), or colorectal cancer.</p> <p>CONCLUSIONS: We observed a lower follow-up for screen-detected abnormalities among blacks when compared with whites but little difference in the yield of colorectal neoplasia. Health-care utilization may be playing more of a role in colorectal cancer racial disparity than biology.</p>
dc.identifier.submissionpathmeyers_pp/464
dc.contributor.departmentMeyers Primary Care Institute
dc.contributor.departmentDepartment of Family Medicine and Community Health
dc.source.pages538-46


This item appears in the following Collection(s)

Show simple item record