Hispanics, Women Less Likely to Be Tested for Colon Cancer

They skip screenings when not reminded by doctors, new study finds.

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HealthDay Reporter

MONDAY, Oct. 25, 2004 (HealthDayNews) -- Colorectal cancer is curable if detected early, but many Americans -- particularly Hispanics and women -- don't get the screening tests.

And they often skip screenings because their doctor didn't remind them, a new study found.

"We found that having both insurance coverage and a regular source of care were the most powerful predictors of whether an individual received a colorectal cancer test," said Ninez A. Ponce, an assistant professor at the University of California, Los Angeles School of Public Health and Center for Health Policy Research.

Ponce and her research team evaluated 2001 data from the California Health Interview Survey. The findings were published in the Oct. 25 online issue of Cancer.

Evaluating responses from more than 22,000 respondents aged 50 and older, Ponce found that about 54 percent said they had had a recent test for colorectal cancer. People aged 65 and older were more likely than younger adults to be tested, and men were 20 percent to 30 percent more likely to be screened than women.

Hispanics were much less likely to get screened than whites. For example, just 33 percent of Hispanics aged 50 to 64 said they'd had a recent screening, compared to 51 percent of whites.

Why don't more people get tested for colorectal cancer, which will be diagnosed in nearly 147,000 people in the United States this year and cause more than 56,000 deaths? Lack of health insurance was often cited as a hurdle, but the most common reason was that a person's doctor did not remind them an exam was needed, Ponce said. Other common responses: People skipped the test because they didn't think about it, or they said they had no symptoms and thought they didn't need the test.

To detect colorectal cancer early, the American Cancer Society recommends that people 50 or older who are at average risk should have:

  • a fecal occult blood test every year, or,
  • a flexible sigmoidoscopy every five years, or,
  • a fecal occult blood test every year plus flexible sigmoidoscopy every five years, or,
  • a double-contrast barium enema every five years, or,
  • a colonoscopy every 10 years.

Of the first three options, the combination of fecal occult blood test every year and flexible sigmoidoscopy every five years is preferable, the cancer society said. Those at increased risk, due to inflammatory bowel disease, or family or personal history, should undergo screening earlier and may need more intensive testing.

More than 90 percent of colorectal cancers are diagnosed in persons over age 50, the cancer society said. Other risk factors, besides family history, include smoking, alcohol consumption, lack of exercise, high-fat diets, inadequate intakes of fruits and vegetables and obesity.

While the rate of testing in California, at 54 percent, is higher than the national rate -- 41 percent for men and 38 percent for women in 2000 -- the rates should be higher, the study authors said.

Another health-care expert familiar with the new study said it provides valuable information about the screening habits of ethnic groups, an area that has been overlooked.

"What really struck me was [the effect of] having a usual source of care," said Ann Zauber, an associate attending at Memorial Sloan-Kettering Cancer Center in New York City who is well-versed on colorectal cancer prevention.

People who did have a regular health-care provider were more likely to get the test because their doctor recommended it.

Concerning the gender differences uncovered by the study, Zauber said, "There is a perception that colon cancer is a higher risk for men than for women." But if women's longer life spans are taken into account, the rates are comparable between genders, she said.

The take-away message for consumers, Zauber said, is that "colorectal cancer screening really can have an effect on colon cancer mortality."

Ponce agreed: "Consumers need to know that the colorectal cancer tests are prevention measures and can save lives. Once they turn 50, they should ask their doctors about getting tested for colorectal cancer."

More information

To learn more about colorectal cancer, visit the American Cancer Society.

SOURCES: Ninez A. Ponce, Ph.D., assistant professor, School of Public Health and Center for Health Policy Research, University of California, Los Angeles School of Public Health; Ann Zauber, Ph.D., associate attending, Memorial Sloan-Kettering Cancer Center, New York City; Oct. 25, 2004, Cancer online

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