Racial Disparities and Factors Affecting Michigan Colorectal Cancer Screening

Introduction: The objective of this study was to investigate the various factors that influence colorectal cancer screening in Michigan using 6091 participants in the Michigan Behavioral Risk Factor Surveillance System representing adults ≥ 50 years old. Methods: Screening for colorectal cancer was assessed as fecal occult blood testing or colonoscopy/sigmoidoscopy. Full models simultaneously adjusted for alcohol use, angina/coronary heart disease, stroke, heart attack, gender, income, marital status, race, age, diabetes, disability, exercise, health care coverage, health care access, smoking, and mental health. Data analysis included cross-tabulation and logistic regression modeling. Results: Minorities were 1.3 (unadjusted odds ratio; 95% confidence interval = 1.03–1.57) times more likely to never have a colonoscopy/sigmoidoscopy than non-Hispanic whites. Race/ethnicity was not significant in the full model, but adults with the following characteristics were significantly (p < 0.05) more likely to never have a colonoscopy/sigmoidoscopy: no personal doctor/health care provider, no health care coverage, light alcohol consumption ≤ 25% of days, no alcohol consumption, low income < $15,000, 50–64 years old, no diabetes, no activity limitation, no exercise, smoked daily, and smoked some days. Conclusion: The racial disparity in colorectal cancer screening in Michigan was explained by other characteristics. The healthcare community can work to eliminate racial disparities in colorectal cancer screening by increasing screening efforts for individuals with these characteristics.