Many minority patients do not receive or complete colorectal cancer screening tests in urban, primary care settings

Disparities/Minority Health
Many minority patients do not receive or complete colorectal cancer screening tests in urban, primary care settings

Colorectal cancer is a preventable and treatable disease if people take advantage of appropriate screening tests such as colonoscopies. Despite the encouraging news on prevention and treatment, the condition remains the second leading cause of death from cancer in the United States. Those most vulnerable are minority and poor populations who are usually diagnosed at an advanced stage of colorectal cancer. Troubling findings from a new study found that the majority of such patients are not receiving appropriate testing and are failing to complete such tests when they are prescribed.

Researchers looked at 246 Hispanic and 50 black patients aged 50 years and older receiving care at a large outpatient primary care clinic in Los Angeles. They reviewed patients' medical records and logbooks of colorectal screening procedures undergone by patients. In addition, they interviewed patients for 20 minutes. More than 70 percent of participants received a recommendation from a health care provider to undergo colorectal cancer screening. However, approximately 24 percent with risk factors for the disease reported never receiving a physician recommendation for testing. The majority of patients with risk factors never scheduled testing (66 percent) or actually completed it (74 percent).

In addition, 74 percent of all participants had never received a colonoscopy, sigmoidoscopy, or a barium enema. Nearly three out of four patients had a fecal occult blood test within the last 2 years; 5 percent had a positive result. Of the patients scheduled for either a colonoscopy or a sigmoidoscopy, only around half completed the procedure. In the case of 39 participants with a family history for colorectal cancer, 31 received a recommendation for screening, but only 10 were scheduled. Health care providers need to communicate better with patients about the importance of following through with recommended colorectal cancer testing, conclude the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS14022).

See "Colorectal cancer screening among underserved minority population: Discrepancy between physicians' recommended, scheduled, and completed tests," by Mohsen Bazargan, Ph.D., Chizobam Ani, M.D., Shahrzad Bazargan-Hejazi, Ph.D., and others in the 2009 Patient Education and Counseling 76, pp. 240-247.