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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Dec 10, 2015; 7(18): 1300-1305
Published online Dec 10, 2015. doi: 10.4253/wjge.v7.i18.1300
Race and colorectal cancer screening compliance among persons with a family history of cancer
Adeyinka O Laiyemo, Nicole Thompson, Carla D Williams, Kolapo A Idowu, Kathy Bull-Henry, Zaki A Sherif, Edward L Lee, Hassan Brim, Hassan Ashktorab, Elizabeth A Platz, Duane T Smoot
Adeyinka O Laiyemo, Hassan Ashktorab, Division of Gastroenterology, Department of Medicine, Howard University College of Medicine, Washington, DC 20060, United States
Nicole Thompson, Carla D Williams, Kolapo A Idowu, Howard University Cancer Center, Washington, DC 20060, United States
Kathy Bull-Henry, Department of Medicine, Georgetown University, Washington, DC 20007, United States
Zaki A Sherif, Department of Biochemistry and Molecular Biology, Howard University College of Medicine, Washington, DC 20060, United States
Edward L Lee, Hassan Brim, Department of Pathology, Howard University, Washington, DC 20060, United States
Elizabeth A Platz, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
Elizabeth A Platz, the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21205, United States
Duane T Smoot, Department of Medicine, Meharry Medical Center, Nashville, TN 37208, United States
Author contributions: All authors contributed to this manuscript.
Supported by In part grant awards from Charles and Mary Latham Funds, the National Center for Advancing Translational Science, Nos. KL2TR000102-04 and UL1RT000101; the National Institute for Diabetes, Digestive Diseases and Kidney, No. R21DK100875; National Institutes of Health (to Dr Laiyemo); and Dr. Platz was supported by NCI P30 CA006973.
Institutional review board statement: The study was approved (exempt) by the Institutional Review Board of Howard University, Washington DC (Reference = IRB-14-MED-28).
Informed consent statement: Not applicable: This is an analysis of de-identified publicly available data.
Conflict-of-interest statement: None.
Data sharing statement: Not applicable. The data is publicly available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adeyinka O Laiyemo, MD, MPH, Division of Gastroenterology, Department of Medicine, Howard University College of Medicine, 2041 Georgia Avenue, NW, Washington, DC 20060, United States.
adeyinka.laiyemo@howard.edu
Telephone: +1-202-8657186 Fax: +1-202-8654607
Received: July 22, 2015
Peer-review started: July 24, 2015
First decision: August 25, 2015
Revised: September 18, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 10, 2015
Processing time: 138 Days and 15.5 Hours
AIM: To determine compliance to colorectal cancer (CRC) screening guidelines among persons with a family history of any type of cancer and investigate racial differences in screening compliance.
METHODS: We used the 2007 Health Information National Trends Survey and identified 1094 (27.4%) respondents (weighted population size = 21959672) without a family history of cancer and 3138 (72.6%) respondents (weighted population size = 58201479) with a family history of cancer who were 50 years and older. We defined compliance with CRC screening as the use of fecal occult blood testing within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We compared compliance with CRC screening among those with and without a family member with a history of cancer.
RESULTS: Overall, those with a family member with cancer were more likely to be compliant with CRC screening (64.9% vs 55.1%; OR = 1.45; 95%CI: 1.20-1.74). The absolute increase in screening rates associated with family history of cancer was 8.2% among whites. Hispanics had lowest screening rates among those without family history of cancer 41.9% but had highest absolute increase (14.7%) in CRC screening rate when they have a family member with cancer. Blacks had the lowest absolute increase in CRC screening (5.3%) when a family member has a known history of cancer. However, the noted increase in screening rates among blacks and Hispanics when they have a family member with cancer were not higher than whites without a family history of cancer: (54.5% vs 58.7%; OR = 1.16; 95%CI: 0.72-1.88) for blacks and (56.7% vs 58.7%; OR = 1.25; 95%CI: 0.72-2.18) for Hispanics.
CONCLUSION: While adults with a family history of any cancer were more likely to be compliant with CRC screening guidelines irrespective of race/ethnicity, blacks and Hispanics with a family history of cancer were less likely to be compliant than whites without a family history. Increased burden from CRC among blacks may be related to poor uptake of screening among high-risk groups.
Core tip: It is unclear whether suboptimal screening contributes to the increased risk of cancer within families. We evaluated compliance with colon cancer screening guidelines among adults in the United States. Our study suggested that adults with a family history of any cancer had higher screening rates, but the smallest increase was noted among blacks. Overall, screening was lower among blacks and Hispanics to such an extent that screening among those with a family member with cancer was not higher than screening among whites without a family member with cancer. There is a particular need to improve screening among high risk blacks.
