Colon cancer diagnosis higher, screening lower in African-Americans, poor people

Dec. 20 (UPI) -- Race and socioeconomic status may play a role in whether American adults are properly screened for colon cancer, a new study has found.

In research published Friday in the JAMA Network Open, African-American participants and those with lower reported household incomes were less likely to undergo a colonoscopy or sigmoidoscopy than white study subjects.

These groups were also more likely to ultimately be diagnosed with type of colorectal cancer, the authors found.

"Our study results suggest that efforts in public health may improve CRC screening rates with implementation strategies that focus on these high-risk groups and that aim to lower barriers," the researchers wrote. "These barriers include limited access to gastroenterologists to perform screening or diagnostic colonoscopy and cost-prohibitive out-of-pocket expenses.

The findings were based on data from the Southern Community Cohort Study, which enrolled more than 85,000 participants from community health centers in 12 states in the southeastern United States. It included data from cohort members who were eligible for colorectal cancer screening as recommended by expert organizations based on age and family history.

The authors tracked more than 47,000 participants, just over 60 percent of whom were African-American. In all, approximately 55 percent of the study participants had household incomes less than $15,000 per year. A total of 64 percent of the participants had yet to undergo any colorectal cancer screening -- colonoscopy or sigmoidoscopy -- at the beginning of the study.

At the start of the study, approximately 40 percent of the white participants had had lower endoscopy evaluations done, compared to just roughly 35 percent of African-Americans. And, just 20 percent of the uninsured participants had had one prior to the start of the study.

Notably, having a colonoscopy or sigmoidoscopy reduced colon cancer risk within the study population by nearly 50 percent.

Those who subsequently developed colorectal cancer tended to be older -- mean 63 years of age -- and more likely to be African-American, have lower household income and have a history of smoking cigarettes than those who remained cancer-free at the end of the study.

Although just 1.3 percent of the participants were diagnosed with the disease, African-Americans were approximately 40 percent more likely to be diagnosed than white participants.

Rates of colorectal cancer were also about three times higher for those with household incomes less than $15,000 a year, and risk for the disease was up to 50 percent higher among current and former smokers than those who never smoked.