Disparities in Colorectal Cancer Screening in Latinos and Non-Hispanic Whites

Colorectal cancer is the second leading cause of cancer deaths in Latinos in the U.S., but it is unclear, from previous research, whether Latinos have differing rates of colorectal cancer screening methods from those of non-Hispanic Whites. This study used electronic health records from 686 communit...

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Published inAmerican journal of preventive medicine Vol. 62; no. 2; pp. 203 - 210
Main Authors Heintzman, John D., Ezekiel-Herrera, David N., Quiñones, Ana R., Lucas, Jennifer A., Carroll, Joseph E., Gielbultowicz, Sophia H., Cottrell, Erika C., Marino, Miguel
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Inc 01.02.2022
Elsevier Science Ltd
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Summary:Colorectal cancer is the second leading cause of cancer deaths in Latinos in the U.S., but it is unclear, from previous research, whether Latinos have differing rates of colorectal cancer screening methods from those of non-Hispanic Whites. This study used electronic health records from 686 community health centers across 21 states in the Accelerating Data Value Across a National Community Health Center of the National Patient-Centered Clinical Research Network. Records from English-preferring Latinos, Spanish-preferring Latinos, and non-Hispanic Whites aged 50–75 years were included. A total of 5 outcomes were compared between 2012 and 2017 to provide a comprehensive view of colorectal cancer screening: (1) any colorectal cancer screening, (2) stool-based screening, (3) annual rates of stool testing, (4) any referral for lower gastrointestinal endoscopy, and (5) endoscopy referral among patients with a positive stool-based screening. In this study (N=204,243), Spanish-preferring Latinos had higher odds of any colorectal cancer screening (OR=1.44, 95% CI=1.23, 1.68) and stool-based testing (OR=1.82, 95% CI=1.55, 2.13) than non-Hispanic Whites. English- and Spanish-preferring Latinos had lower odds of having ever had a referral for endoscopy in the study period than non-Hispanic Whites (English: OR=0.23, 95% CI=0.15, 0.34; Spanish: OR=0.55, 95% CI=0.40, 0.74), even with a positive stool-based screening (English: OR=0.14, 95% CI=0.06, 0.33; Spanish: OR=0.33, 95% CI=0.19, 0.57). In a multistate network of community health centers, Latino patients aged >50 years were more likely to receive stool-based screening tests for colorectal cancer than non-Hispanic Whites but were less likely to receive endoscopy referrals than non-Hispanic Whites, even when experiencing a positive stool-based screening test. Initiatives to improve Latino colorectal cancer outcomes should encourage indicated referrals for lower gastrointestinal endoscopy.
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Author contributions are as follows: Dr. Heintzman, Marino, and Mr. Ezekiel-Herrera conceptualized the study design. Dr. Marino and Mr. Ezekiel-Herrera performed the analysis. All authors contributed to interpretation of findings and critically edited the manuscript.
ISSN:0749-3797
1873-2607
1873-2607
DOI:10.1016/j.amepre.2021.07.009