Race-ethnicity and the effect of screening FSG on colorectal cancer incidence and mortality
Principal Investigator
About this CDAS Project
Study
PLCO
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Project ID
2012-0232
Initial CDAS Request Approval
Jul 18, 2012
Title
Race-ethnicity and the effect of screening FSG on colorectal cancer incidence and mortality
Summary
Blacks have the highest incidence of colorectal cancer (CRC) and mortality from the disease of any race-ethnicity in the United States (1-3). Some studies have suggested biological susceptibility differences (4-6). However, there is evidence that black-white differences in CRC risk may be related to differences in access to, or use of, healthcare services (7-11). In our previous studies within the PLCO (12), we found that blacks were as likely to have abnormal suspicious screening FSG as whites, but were less likely to undergo disgnostic colonoscopy within 1 year of the abnormal screening. Among subjects with abnormal FSG who underwent diagnostic colonoscopy, there was no meaningful differences in the risk of adenoma, advanced adenoma or cancer when compared to whites. This study suggests that healthcare utilization may be playing more of a role in CRC disparity by race. However, no study has evaluated whether blacks and whites have similar benefit from CRC screening
Aims
We hypothesize that when healthcare access and utilization is equitable, blacks will have comparable burden of CRC as whites. Our specific aims are: 1. To determine the incidence of CRC after FSG screening among whites, blacks, Hispanics and other races 2. To determine the mortality (all cause and CRC specific mortality) among whites, blacks, Hispanics and other races