Colorectal Cancer Screening and Race in an Equal Access Medical System

Area of Science:

• Public Health
• Health Disparities
• Gastroenterology

Background:

• National colorectal cancer (CRC) screening rates show improvement but highlight persistent racial disparities.
• Improved access to care is often proposed as a solution to eliminate these disparities.

Purpose of the Study:

• To investigate if racial disparities in CRC screening rates persist within a healthcare system that has eliminated access and cost barriers.
• To identify potential patient-specific factors contributing to screening inequities.

Main Methods:

• Retrospective review of Healthcare Effectiveness Data and Information Set (HEDIS) data.
• Analysis of CRC screening rates and up-to-date screening status for patients aged 50-65.
• Examination of screening data stratified by race.

Main Results:

• Overall CRC screening and up-to-date rates (81% and 72%) exceeded national averages.
• Black patients were less likely than non-Black patients to be screened (75% vs. 82%, p < 0.001) and up-to-date (66% vs. 72%, p < 0.001).
• Racial disparities in CRC screening persisted despite the absence of access and cost barriers.

Conclusions:

• Eliminating access and cost barriers alone is insufficient to resolve racial disparities in CRC screening.
• Further investigation into patient-specific barriers is crucial for improving CRC screening equity.
• Strategies beyond access are needed to address national trends in CRC screening disparities.