Trends in colorectal cancer screening disparities in people aged 50-64 years, 2000-2005

Am J Prev Med. 2008 Sep;35(3):185-93. doi: 10.1016/j.amepre.2008.05.021. Epub 2008 Jul 10.


Background: Colorectal cancer (CRC) screening rates are low, and racial, ethnic, and economic disparities have been reported. Whether disparities in CRC screening have decreased over time is unknown. This study aimed to determine whether progress was made between 2000 and 2005 in reducing CRC screening disparities by race, ethnicity, income, and insurance status.

Methods: Age-adjusted percentages of participants aged 50-64 who reported CRC screening (home fecal occult blood test in the past year or endoscopy in the past 10 years) were estimated from the 2000 (n=6,020 participants) and 2005 (n=6,706) cancer control supplements of the National Health Interview Survey, with analysis in 2007.

Results: Screening rates did not increase between 2000 and 2005 for Hispanic women or uninsured women. Only for high-income participants did screening exceed 50%. For both men and women, the uninsured had the lowest levels of screening (19.1% and 19.3%, respectively, in 2005), and the greatest disparities were observed among groups defined by health insurance status. For women, disparities by ethnicity, income, and insurance status increased over time, whereas among men, disparities in 2005 were similar to those in 2000. For Hispanic women, growing disparities were present at all income and insurance levels and persisted after additional adjustment.

Conclusions: No progress was made in reducing most CRC screening disparities between 2000 and 2005. Methods are needed to increase CRC screening among everyone, but in particular Hispanic women and uninsured men and women.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / prevention & control
  • Female
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Health Status Disparities*
  • Hispanic Americans
  • Humans
  • Male
  • Mass Screening / statistics & numerical data*
  • Mass Screening / trends*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Socioeconomic Factors
  • United States / epidemiology