Geography also played a significant role in screening rate variations among African Americans, Semrad found. For example, in the state of Iowa, African Americans and whites had nearly identical screening rates, suggesting that access to screening is similar and that providers are recommending screening to Medicare enrollees regardless of their race or ethnicity.
The same was not true in the city of San Jose, Calif., where whites had similar screening rates to whites in Iowa (45 percent), but where screening rates among African Americans (29 percent) were among the lowest found in the study.
Researchers also found substantial disparities when comparing white and Hispanic screening rates in all regions that had substantial Hispanic populations. But unlike the Asian and African-American groups, there was virtually no difference in screening rates among Hispanics in the different regions.
Explaining the geographic variations in screening rates among non-whites will require much more detailed research, Semrad said. But he suspects that non-whites in some regions may be segregated within primary care practices and health systems that may be less likely to provide colorectal cancer screening. Less access to primary care and to gastrointestinal specialists also may play a significant role in these variations.
A possible explanation of variation among Asian-Pacific Islanders is ethnicity and cultural differences that may influence attitudes toward preventive care and cancer screening, Semrad said. Other research shows that Chinese immigrants in Seattle, for example, may opt for more traditional methods such as maintenance of energy (qi) and spririt (jing shen), exercise and diet for prevention rather than medical screening.
"The next step is to look at different geographic areas to
|Contact: Dorsey Griffith|
University of California - Davis Health System