Racial Impact of Hypertension on Colorectal Cancer Screening in Central Illinois, United States

Introduction Colorectal cancer (CRC) is one of the most common types of cancer in the United States. We evaluated the association between hypertension and CRC screening in the American population in Central Illinois. We performed the analysis by investigating the association between hypertension and CRC screening in the American population in Central Illinois, specifically African Americans, to detect disparities. Methods Using electronic medical records from an Illinois healthcare system, we analyzed patients aged 45-75 years between January 2014 and December 2023. The data reviewed included factors such as race, age, gender, education, and hypertension. Race categories were White, African American, and others including Hispanics, Asians, Native Americans, Pacific Islanders, Samoans, and unclassified races. Exclusions were patients outside the age limit or those diagnosed with CRC without screening. We recorded frequencies and percentages for categorical variables and statistical measures for numeric ones. The Pearson chi-squared test evaluated the association between race and CRC screening. Data analysis was performed in R at a 5% significance level. Results Among screened patients, 2,264 (75.4%) African American, 14,446 (52.1%) White, and 650 (48.4%) others had hypertension. Of those testing positive for CRC, 14 (73.7%) African American, 1 (25%) "others," and 53 (52%) White patients had hypertension. Overall, 68 (54.4%) of the CRC-positive population had hypertension. An association between hypertension and CRC screening was found (p < 0.001), with higher screening rates among hypertensive African Americans compared to other races. Though hypertensive African Americans had higher CRC positivity rates, the small case numbers warrant validation in larger cohorts. Conclusion In Central Illinois, African Americans showed the highest rates of hypertension and positive CRC diagnoses in the screened population. They are at higher risk of CRC when hypertensive. Targeted community-based screening programs for hypertensive African Americans, coupled with culturally tailored education on CRC prevention, may reduce disparities in early detection and outcomes.