The late-stage diagnosis of colorectal cancer: demographic and socioeconomic factors.

Abstract

OBJECTIVES: This study described factors related to colorectal cancer stage at diagnosis. METHODS: Logistic regression analyses were used on data from the New York State Tumor Registry and US Census area-level social class indicators. RESULTS: After the effects of other predictors were controlled for, the odds of late-stage cancer increased as age decreased; women and African Americans were significantly more likely to have late stage than men and Whites; and individuals living in areas of low socioeconomic status (SES) were significantly more likely to be diagnosed at late stage than those living in higher SES areas. Stratified analyses showed that living in a low SES area was the most important determinant of stage for all age, race, gender and source-of-care groups. CONCLUSIONS: While all populations would benefit from the systematic use of screening socioeconomically disadvantaged groups may also benefit from targeted screening.

Improving Colorectal Cancer Screening Among the Medically Underserved: A Pilot Study within a Federally Qualified Health Center

“…In particular, the African-American population has the highest morbidity and mortality rate owing to colorectal cancer, and the Hispanic population has the lowest screening rates, putting this group at greater risk for late-stage presentation of the disease. [6][7][8][9][10] Our research team recently investigated screening completion rates among a network of 31 federally qualified health centers (FQHCs) whose mission is to provide comprehensive primary care in areas where there are large volumes of low-income and medically underserved populations. 10,11 The screening rates among these predominantly African-American and Hispanic communities were the lowest recorded in the literature to date; only 7% of eligible patients were found to be compliant with colorectal cancer screening (predominantly FOBT).…”

Knowledge and perceptions of colorectal cancer screening among urban African Americans

“…[19][20][21][22] African Americans have exhibited higher rates of late-stage CRC diagnosis and less overall decline in colorectal deaths than whites over the past decade. [23][24][25] Barriers to CRC screening include the inconvenient or impractical nature of the tests, [26][27][28][29] the embarrassing or unpleasant nature of the tests, 28,29 fatalistic cancer beliefs, 30,31 and participants not wanting to know that something is wrong. 28,32,33 Studies of African Americans have shown that these barriers and others, such as lack of physician recommendation, limited CRC knowledge, and the uncomfortable nature of tests, may contribute to inadequate screening 16,[34][35][36] Although prior qualitative studies have explored how knowledge, socio-culturally mediated attitudes and perceptions, and testing preferences influence screening for breast and prostate cancer among African Americans, [37][38][39][40] few qualitative studies have been conducted with African Americans on CRC screening.…”

Does access to private healthcare influence potential lung cancer cure rates?

“…[17,18] Although numerous studies across various cancers have shown that poor SES has been associated with late-stage diagnosis, this has not been consistently observed in studies looking at NSCLC in isolation. [18][19][20][21] Disparities in access to healthcare and its use, as well as lack of preventive healthcare services including cancer screening, may contribute somewhat to differentials in cancer stage distributions, especially in late-stage diagnosis. [18,[22][23][24][25] …”