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An examination of early colorectal cancer screening guidelines for African Americans: Hints from the HINTS data

机译：对非洲裔美国人早期结直肠癌筛查指南的检查：来自HINTs数据的提示

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Background: Despite the overall gains in reducing colorectal cancer (CRC) deaths due to the increase in screening, minority racial/ethnic groups who have disparately higher rates of death compared to Whites, also have disproportionately lower screening rates. Patient-provider communication about screening has a strong influence on the uptake of screening. In much the same way that gradual impact was made after the 1996 implementation of guidelines recommending screening starting at age 50 for those at average risk, it may be expected that the American College of Gastroenterology (ACG) guidelines suggesting screening start at 45 for Blacks combined with a recent trend toward increasing incidence of cancer in persons below the age of 50 might influence practitioners to offer screening with greater frequency to those younger minority groups. Methods: This study examines HINTS Cycle 4 data to examine the nationally representative rates at which providers offer patients the option to be screened for CRC, with emphasis on Blacks ages 45-49. We looked for a trend in these rates over time, compared the pooled proportion estimates across racial/ethnic groups aged 45-49, and compared the proportion of Black individuals in this age group to those between ages 50 and 75 who had been told they could choose to have a CRC screening. Results: Approximately 27.14% of Black individuals aged 45-49 had been offered the option of CRC screening by a healthcare provider compared to 32.57% of White individuals of the same age group and 43.53% of Black individuals age 50-75. Discussion: There is not yet any evidence of an increase in adherence to the ACG guidelines for the Black population aged 45-49 and there remains a significant racial disparity in discussion of the CRC screening option. Earlier information regarding the option to be screened may have the potential to reduce disparities CRC screening and mortality, as well as potentially halt a disturbing trend toward early cancers.
机译：背景：尽管由于筛查的增加而在减少结直肠癌（CRC）死亡方面总体上有所收获，但与白人相比死亡率较高的少数种族/族裔人群的筛查率也较低。病人与提供者之间关于筛查的交流对筛查的吸收有很大影响。与1996年实施指南建议从50岁开始筛查中等风险人群后逐渐产生影响的方式几乎相同，可以预期美国胃肠病学（ACG）指南建议从45岁开始筛查黑人人群随着最近50岁以下人群癌症发病率增加的趋势，可能会影响从业者向年轻的少数民族人群提供更高频率的筛查。方法：本研究检查了HINTS第4周期的数据，以检验提供服务的国家为患者提供的筛查CRC的选项的全国代表性比率，重点是45-49岁的黑人。我们寻找了这些比率随时间变化的趋势，比较了45-49岁各个种族/族裔群体的混合比例估计值，并将该年龄段的黑人个体与50-75岁之间被告知可以选择进行CRC筛查。结果：大约27.14％的45-49岁黑人个体已获得医疗服务提供者的CRC筛查选项，而同一年龄段的白人个体中有32.57％，而50-75岁黑人个体中有43.53％。讨论：尚无任何证据表明，针对45-49岁的黑人人口遵守ACG指南的情况有所增加，并且在讨论CRC筛查方法时，种族差异仍然很大。有关要选择的筛查方法的早期信息可能会减少CRC筛查和死亡率的差异，并有可能阻止对早期癌症的令人不安的趋势。

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