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Region Affects Race Disparity in Colorectal Cancer Screening

Greatest black-white screening disparities in Atlanta, rural Georgia, and San Francisco Bay area

MONDAY, Jan. 10 (HealthDay News) -- Colorectal screening among the nonwhite population in the United States appears to vary according to region compared to whites, who have little geographic variation in colorectal screening, according to a study published online Jan. 15 in Cancer.

Thomas J. Semrad, M.D., of the University of California Davis Sacramento, and colleagues investigated CRC screening status in Medicare enrollees within eight U.S. states. Individuals were considered up-to-date on screening if they had fecal occult blood testing in the previous year or sigmoidoscopy or colonoscopy within the last five years. They compared prevalence of up-to-date status in whites versus nonwhites across the regions.

The study team found little geographic variation in up-to-date status among whites, who were generally more likely to be screened than nonwhites. White versus nonwhite up-to-date status varied significantly across regions for blacks and Asian/Pacific Islanders (APIs) but not for Hispanics. White versus black differences in screening status were greatest in Atlanta, rural Georgia, and the San Francisco Bay Area (10 to 16 percent differences). In Connecticut, Seattle, and Iowa, there were no significant white versus black differences. APIs had lower up-to-date prevalence than whites in Michigan and areas in California (4 to 15 percent differences), but higher up-to-date prevalence than whites in Hawaii (52 percent versus 38 percent). White versus Hispanic differences were substantial but did not vary significantly by geographic region.

"Research is needed to elucidate the local and regional barriers that impair CRC screening among nonwhite populations in some US locations but not others," the authors write.

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