Colorectal cancer screening among underserved Hispanic and African Americans receiving medical care from safety-net, primary care settings Free

B64

Colorectal carcinoma (CRC) racial disparities have widened during last three decades and the racial differences in prevention practice patterns has been blamed for excessive morbidity among minority populations. Specific Aims of this study were threefold: 1) to examine the correlates of CRC testing in socio-economically disadvantaged Latinos and African Americans receiving medical care from safety-net, primary care settings; 2) to examine the patient characteristics associated with self-reported physician recommendation of CRC screening and 3) to examine factors associated with adherence to recommended colorectal cancer testing including barriers, attitudes and beliefs. Design: Cross-sectional survey of clinic-based sample. Setting: Large urban safety net, out-patient primary care setting served by 33 family medicine physicians in the County of Los Angeles. Participants: Three hundred and six African-American and Latino patients aged 50 years and older. Results: Fifty-four percent of participants self-reported physician recommendation of lower endoscopic procedures for CRC testing and of these 74% adhered with the recommend tests. Physician recommendation was the most significant predictor of CRC testing. Age, medical conditions associated with CRC risk, and recent fecal occult blood test were all associated with an increased likelihood of physician recommendation of CRC testing. Ethnicity, marital status, medical conditions associated with CRC risk, barriers to CRC testing, were significantly associated with adherence with recommended CRC testing. Conclusion: Over 60% of minority underserved individuals do not receive or adhere to standard CRC testing schedules in the urban safety net, out-patient primary care setting. Interventions that both emphasize CRC screening recommendation by providers in these settings and promote patient adherence, will reduce the disparities and the burden of colorectal cancer in minority underserved populations.