Racial and ethnic minorities less likely to be screened for colorectal cancer in the U.S.

A new study conducted in the Center for Health Policy at the University of Nebraska Medical Center College of Public Health has determined that racial and ethnic minorities are less likely to be screened for colorectal cancer in the United States.

The study, which analyzed data from across the country between 2000 and 2005, was conducted by Jim Stimpson, Ph.D., director of the Center for Health Policy at UNMC. Results were published in the December issue of the public health journal, Health Affairs.

The data revealed that 42 percent of Caucasians were screened for colorectal cancer, compared to 36 percent of African Americans, 31 percent of Asian and Native Americans and 28 percent of Hispanics.

"This is evident of a significant health disparity of a preventable yet fatal disease affecting thousands of people in the United States," Dr. Stimpson said.

Another interesting aspect of the study showed that characteristics of a community could impact screenings rates, such as those areas with a low supply of gastroenterologists or counties without health insurance, Dr. Stimpson said.

There is an assumption that only lack of access and money are the primary barriers of getting screenings, but this study found that for people of ethnicity - African Americans, Hispanics and Native Americans - other factors come into play, he said.

Those factors include transportation barriers, paid time off from work and health literacy.

In particular, among Hispanics high levels of fatalism and low levels of health literacy among low income earners may play a role in whether the person seeks out screening, Dr. Stimpson said.

"Racial and ethnic minorities have unique challenges navigating the health care system, in some cases because they are immigrants and there are language issues, or they live in areas with high levels of uninsurance, or are in areas with few gastroenterologists," he said.

His suggested solutions include:
• Identifying incentives for health care providers to perform colonoscopies in underserved areas,
• Facilitate screenings by transporting patients to clinics,
• Reimbursing physicians more to perform procedures in underserved areas,
• Training other health care providers to conduct colonoscopies under the supervision of a gastroenterologist via telemedicine.

"Colorectal cancer screening saves lives," Dr. Stimpson stressed. "We need to increase the number of people who get this screening, and especially focus on solutions that reduce the disparity in screening for racial or ethnic minorities."

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