Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African Americans
Abstract Background African Americans (AAs) have had lower colorectal cancer (CRC) screening rates, higher incidence rate, and earlier mean age at onset. The 2017 U.S. Multi‐Society Task Force (MSTF) recommended initiating CRC screening at age 45 for AAs and age 50 for non‐AAs. Objective To investig...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.4842 |
| _version_ | 1797980083089047552 |
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| author | Hyo Jung Tak I‐Wen Pan Michael T. Halpern Ya‐Chen Tina Shih |
| author_facet | Hyo Jung Tak I‐Wen Pan Michael T. Halpern Ya‐Chen Tina Shih |
| author_sort | Hyo Jung Tak |
| collection | DOAJ |
| description | Abstract Background African Americans (AAs) have had lower colorectal cancer (CRC) screening rates, higher incidence rate, and earlier mean age at onset. The 2017 U.S. Multi‐Society Task Force (MSTF) recommended initiating CRC screening at age 45 for AAs and age 50 for non‐AAs. Objective To investigate the impact of the 2017 MSTF's race‐specific guidelines on CRC screening rate among young AAs. Design, setting, and participants We used the 2015 and 2018 National Health Interview Survey to provide nationally representative estimates. The study sample included adults aged between 45 and 75 without a history of CRC, excluding screening recipients for diagnosis or surveillance purposes. Main measures The outcome is a binary variable of CRC screening. Primary independent variables were age and race category (non‐AAs aged 45–49, AAs 45–49, non‐AAs 50–75, AAs 50–75), a binary variable indicating before or after the 2017 MSTF guideline (2015 vs. 2018), and their interaction terms. We employed a multivariable logistic model, adjusting for individual characteristics, and accounting for complex survey design. Key results Among the total sample (n = 21,735), CRC screening rate increased from 54.6% in 2015 to 58.5% in 2018 (p < 0.01). By age and race, the screening rate exhibited an increase for all age and race groups except for young non‐AAs. Compared to young non‐AAs, the adjusted predicted probability (APP) of screening for young AAs was significantly higher by 0.10 (average marginal effect, 0.10; 95% confidence interval, 0.01–0.19) in 2018, while the difference was insignificant in 2015. Racial differences in screening among older adults were not significant in both years. The CRC screening rate was substantially lower among young AAs compared to older AAs (17.2% vs. 65.5% in 2018). Conclusion The race‐specific recommendation is an effective policy tool to increase screening uptake and would contribute to reducing cancer disparities among racial/ethnic minorities. |
| first_indexed | 2024-04-11T05:48:44Z |
| format | Article |
| id | doaj.art-5372d366bc1b40bba1e9d11fe749efec |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-11T05:48:44Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-5372d366bc1b40bba1e9d11fe749efec2022-12-22T04:42:07ZengWileyCancer Medicine2045-76342022-12-0111245013502410.1002/cam4.4842Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African AmericansHyo Jung Tak0I‐Wen Pan1Michael T. Halpern2Ya‐Chen Tina Shih3Department of Health Services Research and Administration University of Nebraska Medical Center Omaha NE USADepartment of Health Services Research University of Texas MD Anderson Cancer Center Houston TX USAHealthcare Delivery Research Program National Cancer Institute Bethesda MD USADepartment of Health Services Research University of Texas MD Anderson Cancer Center Houston TX USAAbstract Background African Americans (AAs) have had lower colorectal cancer (CRC) screening rates, higher incidence rate, and earlier mean age at onset. The 2017 U.S. Multi‐Society Task Force (MSTF) recommended initiating CRC screening at age 45 for AAs and age 50 for non‐AAs. Objective To investigate the impact of the 2017 MSTF's race‐specific guidelines on CRC screening rate among young AAs. Design, setting, and participants We used the 2015 and 2018 National Health Interview Survey to provide nationally representative estimates. The study sample included adults aged between 45 and 75 without a history of CRC, excluding screening recipients for diagnosis or surveillance purposes. Main measures The outcome is a binary variable of CRC screening. Primary independent variables were age and race category (non‐AAs aged 45–49, AAs 45–49, non‐AAs 50–75, AAs 50–75), a binary variable indicating before or after the 2017 MSTF guideline (2015 vs. 2018), and their interaction terms. We employed a multivariable logistic model, adjusting for individual characteristics, and accounting for complex survey design. Key results Among the total sample (n = 21,735), CRC screening rate increased from 54.6% in 2015 to 58.5% in 2018 (p < 0.01). By age and race, the screening rate exhibited an increase for all age and race groups except for young non‐AAs. Compared to young non‐AAs, the adjusted predicted probability (APP) of screening for young AAs was significantly higher by 0.10 (average marginal effect, 0.10; 95% confidence interval, 0.01–0.19) in 2018, while the difference was insignificant in 2015. Racial differences in screening among older adults were not significant in both years. The CRC screening rate was substantially lower among young AAs compared to older AAs (17.2% vs. 65.5% in 2018). Conclusion The race‐specific recommendation is an effective policy tool to increase screening uptake and would contribute to reducing cancer disparities among racial/ethnic minorities.https://doi.org/10.1002/cam4.4842cancer screeningcolorectal cancerracial disparitiesU.S. multi‐society task force |
| spellingShingle | Hyo Jung Tak I‐Wen Pan Michael T. Halpern Ya‐Chen Tina Shih Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African Americans Cancer Medicine cancer screening colorectal cancer racial disparities U.S. multi‐society task force |
| title | Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African Americans |
| title_full | Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African Americans |
| title_fullStr | Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African Americans |
| title_full_unstemmed | Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African Americans |
| title_short | Impact of race‐specific screening guideline on the uptake of colorectal cancer screening among young African Americans |
| title_sort | impact of race specific screening guideline on the uptake of colorectal cancer screening among young african americans |
| topic | cancer screening colorectal cancer racial disparities U.S. multi‐society task force |
| url | https://doi.org/10.1002/cam4.4842 |
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