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Blacks Less Likely to Get Follow-Up Colon Screening
Date:4/6/2010

Those with abnormalities at initial screening often didn't have recommended colonoscopy, study shows

TUESDAY, April 6 (HealthDay News) -- Black Americans are less likely than whites to have a follow-up colonoscopy after receiving abnormal results on a flexible sigmoidoscopy screening test, says a new study.

Previous studies found that blacks may be at greater risk for colorectal cancer and more likely to die from the disease than whites. It has been unclear whether this disparity was due to differences in access to health care.

In this new study, researchers analyzed data from 60,572 black and white participants in the ongoing Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial who underwent flexible sigmoidoscopy screening between November 1993 and July 2001. That initial screening found suspicious lesions in 25.5 percent of blacks and 23.9 percent of whites.

There were 13,743 white and 767 black men and women referred to their own physician for a follow-up colonoscopy. The follow-up visits weren't paid for by the PLCO trial. Of the participants referred, 9,944 (72.4 percent) of whites and 480 (62.6 percent) of blacks saw a physician and had a colonoscopy.

Among the participants who had a follow-up colonoscopy, there was no statistically significant difference between blacks and whites in the prevalence of polyps, advanced adenomas, advanced pathology in small adenomas, or colorectal cancer.

The study appears online April 6 in the Journal of the National Cancer Institute.

The findings "suggest that the biology of colorectal cancer may not be materially different by race, at least in the early stages of carcinogenesis, but instead that health care utilization differences among the races may play an important role in the observed disparities in colorectal cancer," Dr. Adeyinka O. Laiyemo, from the U.S. National Cancer Institute's division of cancer prevention, a
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