PMID- 20357245
OWN - NLM
STAT- MEDLINE
DCOM- 20100430
LR  - 20221207
IS  - 1460-2105 (Electronic)
IS  - 0027-8874 (Print)
IS  - 0027-8874 (Linking)
VI  - 102
IP  - 8
DP  - 2010 Apr 21
TI  - Race and colorectal cancer disparities: health-care utilization vs different 
      cancer susceptibilities.
PG  - 538-46
LID - 10.1093/jnci/djq068 [doi]
AB  - BACKGROUND: It is unclear whether the disproportionately higher incidence and 
      mortality from colorectal cancer among blacks compared with whites reflect 
      differences in health-care utilization or colorectal cancer susceptibility. 
      METHODS: A total of 60, 572 non-Hispanic white and black participants in the 
      ongoing Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial 
      underwent trial-sponsored screening flexible sigmoidoscopy (FSG) without biopsy 
      at baseline in 10 geographically dispersed centers from November 1993 to July 
      2001. Subjects with polyps or mass lesions detected by FSG were referred to their 
      physicians for diagnostic workup, the cost of which was not covered by PLCO. The 
      records of follow-up evaluations were collected and reviewed. We used log 
      binomial modeling with adjustment for age, education, sex, body mass index, 
      smoking, family history of colorectal cancer, colon examination within previous 3 
      years, personal history of polyps, and screening center to examine whether 
      utilization of diagnostic colonoscopy and yield of neoplasia differed by race. 
      RESULTS: Among 57 561 whites and 3011 blacks who underwent FSG, 13,743 (23.9%) 
      and 767 (25.5%) had abnormal examinations, respectively. A total of 9944 (72.4%) 
      whites and 480 (62.6%) blacks had diagnostic colonoscopy within 1 year following 
      the abnormal FSG screening. When compared with whites, blacks were less likely to 
      undergo diagnostic evaluation (adjusted risk ratio = 0.88, 95% confidence 
      interval = 0.83 to 0.93). Overall, among subjects with diagnostic colonoscopy (n 
      = 10 424), there was no statistically significant difference by race in the 
      prevalence of adenoma, advanced adenoma, advanced pathology in small adenomas 
      (high-grade dysplasia or villous histology in adenomas <10 mm), or colorectal 
      cancer. CONCLUSIONS: We observed a lower follow-up for screen-detected 
      abnormalities among blacks when compared with whites but little difference in the 
      yield of colorectal neoplasia. Health-care utilization may be playing more of a 
      role in colorectal cancer racial disparity than biology.
FAU - Laiyemo, Adeyinka O
AU  - Laiyemo AO
AD  - Department of Medicine, Howard University College of Medicine, Howard University 
      Cancer Center, Washington, DC 20060, USA. adeyinka.laiyemo@howard.edu
FAU - Doubeni, Chyke
AU  - Doubeni C
FAU - Pinsky, Paul F
AU  - Pinsky PF
FAU - Doria-Rose, V Paul
AU  - Doria-Rose VP
FAU - Bresalier, Robert
AU  - Bresalier R
FAU - Lamerato, Lois E
AU  - Lamerato LE
FAU - Crawford, E David
AU  - Crawford ED
FAU - Kvale, Paul
AU  - Kvale P
FAU - Fouad, Mona
AU  - Fouad M
FAU - Hickey, Thomas
AU  - Hickey T
FAU - Riley, Thomas
AU  - Riley T
FAU - Weissfeld, Joel
AU  - Weissfeld J
FAU - Schoen, Robert E
AU  - Schoen RE
FAU - Marcus, Pamela M
AU  - Marcus PM
FAU - Prorok, Philip C
AU  - Prorok PC
FAU - Berg, Christine D
AU  - Berg CD
LA  - eng
GR  - N01-CN-25524/CN/NCI NIH HHS/United States
GR  - N01-CN-25513/CN/NCI NIH HHS/United States
GR  - N01-CN-25511/CN/NCI NIH HHS/United States
GR  - N01-CN-75022/CN/NCI NIH HHS/United States
GR  - N01-CN-25514/CN/NCI NIH HHS/United States
GR  - N01-CN-25512/CN/NCI NIH HHS/United States
GR  - N01-CN-25515/CN/NCI NIH HHS/United States
GR  - K01 CA127118/CA/NCI NIH HHS/United States
GR  - N01-CN-25476/CN/NCI NIH HHS/United States
GR  - N01-CN-25518/CN/NCI NIH HHS/United States
GR  - N01-CN-25516/CN/NCI NIH HHS/United States
GR  - R01 CA151736/CA/NCI NIH HHS/United States
GR  - N01-CN-25404/CN/NCI NIH HHS/United States
GR  - U01 CA151736/CA/NCI NIH HHS/United States
GR  - N01-CN-25522/CN/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20100331
PL  - United States
TA  - J Natl Cancer Inst
JT  - Journal of the National Cancer Institute
JID - 7503089
SB  - IM
CIN - J Natl Cancer Inst. 2010 Apr 21;102(8):511-3. PMID: 20357246
MH  - Black or African American/*statistics & numerical data
MH  - Aged
MH  - Colonoscopy
MH  - Colorectal Neoplasms/*epidemiology/ethnology/genetics/mortality/*prevention & 
      control
MH  - Delivery of Health Care/*statistics & numerical data
MH  - Early Detection of Cancer
MH  - Female
MH  - Genetic Predisposition to Disease
MH  - Healthcare Disparities/*statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Lung Neoplasms/prevention & control
MH  - Male
MH  - Mass Screening/methods/statistics & numerical data
MH  - Middle Aged
MH  - Ovarian Neoplasms/prevention & control
MH  - Prostatic Neoplasms/prevention & control
MH  - Randomized Controlled Trials as Topic
MH  - Risk Factors
MH  - Sigmoidoscopy
MH  - Socioeconomic Factors
MH  - United States/epidemiology
MH  - White People/*statistics & numerical data
PMC - PMC2857802
EDAT- 2010/04/02 06:00
MHDA- 2010/05/01 06:00
PMCR- 2011/04/21
CRDT- 2010/04/02 06:00
PHST- 2010/04/02 06:00 [entrez]
PHST- 2010/04/02 06:00 [pubmed]
PHST- 2010/05/01 06:00 [medline]
PHST- 2011/04/21 00:00 [pmc-release]
AID - djq068 [pii]
AID - 10.1093/jnci/djq068 [doi]
PST - ppublish
SO  - J Natl Cancer Inst. 2010 Apr 21;102(8):538-46. doi: 10.1093/jnci/djq068. Epub 
      2010 Mar 31.