A Comparison of Colorectal Cancer Screening Uptake Among Average-Risk Insured American Indian/Alaska Native and White Women

Abstract

Introduction American Indian and Alaska Native (AI/AN) women have among the lowest rates of colorectal cancer (CRC) screening. Whether screening disparities persist with equal access to health care is unknown. Methods Using administrative data from 1996-2007, we compared CRC screening events for 286 AI/AN and 14,042 White women aged 50 years and older from a health maintenance organization in the Pacific Northwest of the U.S. Results The proportion of AI/AN and White women screened for CRC at age 50 was similar (13.3% vs. 14.0%, p =.74). No differences were seen in the type of screening test. Time elapsed to first screening among AI/AN women who were not screened at age 50 did not differ from White women (hazard ratio 1.0, 95% confidence interval 0.8-1.3). Conclusions Uptake for CRC screening was similar among insured AI/AN and White women, suggesting that when access to care is equal, racial disparities in screening diminish.

Distrust in health care and cultural factors are associated with uptake of colorectal cancer screening in Hispanic and Asian Americans

“…This was unexpected finding and deserves further investigation in future studies. However, variations in CRC screening uptake among Native Americans and Asian subgroups have been documented 50,51 ; therefore, an examination of pathways to CRC screening or other health services utilization in those populations is warranted. 12,14,21,23 There are limitations to this study that must be acknowledged.…”

“…Finally, we did not attempt to assess differences in the pathways to CRC screening among other racial/ethnicity groups, because it was beyond the scope of this study. However, variations in CRC screening uptake among Native Americans and Asian subgroups have been documented 50,51 ; therefore, an examination of pathways to CRC screening or other health services utilization in those populations is warranted.…”

Racial and Ethnic Disparities in the Quality of Health Care

“…In general, insurance is a major contributor to disparities in preventive care, but education, income, cultural attitudes, language, and a usual source of care are also factors (91,95,111). Differences in patient reports in provider recommendations by race or ethnicity are relatively infrequent and small.…”

Parental Ethnic Identity and Its Influence on Children’s Oral Health in American Indian Families

“…For Native populations burdened by extreme health disparities, ethnic identity has been explored relative to general health and the related influence on preventive behaviors and behavioral compliance with medical recommendations [ 9 , 12 , 13 , 14 ]. Some studies have shown that a strong sense of ethnic identification is associated with higher rates of optimal health beliefs and behaviors [ 15 , 16 , 17 , 18 , 19 , 20 ] and better health outcomes [ 9 , 20 , 21 , 22 , 23 , 24 ].…”

“…In other studies, an inverse relationship between ethnic identity and health-promoting behaviors has been discerned. In particular, strong ethnic identity has been linked to suboptimal health behaviors related to tobacco and drug use [ 9 , 14 ] and reduced adherence with cancer screening recommendations [ 12 , 13 , 25 , 26 , 27 ].…”