Colonoscopy screening in African Americans and whites with affected first-degree relatives

Harvey J. Murff, Neeraja B. Peterson, Jay Fowke, Margaret Hargreaves, Lisa B. Signorello, Robert S. Dittus, Wei Zheng, William J. Blot

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Family history is a risk factor for colon cancer, and guidelines recommend initiating screening at age 40 years in individuals with affected relatives. Racial differences in colon cancer mortality could be related to variations in screening of increased-risk individuals. Methods: Baseline data from 41 830 participants in the Southern Community Cohort Study were analyzed to determine the proportion of colonoscopy procedures in individuals with strong family histories of colon cancer, and whether differences existed based on race. Results: In participants with multiple affected first-degree relatives (FDRs) or relatives diagnosed before age 50 years, 27.3% (95% confidence interval [CI], 23.5%-31.1%) of African Americans reported having a colonoscopy within the past 5 years compared with 43.1% (95% CI, 37.0%-49.2%) of white participants (P<.001). African Americans in this group had an odds ratio of 0.51 (95% CI, 0.38-0.68) of having undergone recommended screening procedures compared with white participants after adjusting for age, sex, educational status, annual income, insurance status, total number of affected and unaffected FDRs, and time since last medical visit. African Americans with multiple affected FDRs or relatives diagnosed before age 50 years and who had ever undergone endoscopy were less likely to report a personal history of colon polyps (odds ratio,0.29; 95% CI, 0.20-0.42) when compared with whites with similar family histories. Conclusions: African Americans who have FDRs with colon cancer are less likely to undergo colonoscopy screening compared with whites who have affected relatives. Increased efforts need to be directed at identifying and managing underserved populations at increased risk for colon cancer based on their family histories.

Original languageEnglish (US)
Pages (from-to)625-631
Number of pages7
JournalArchives of Internal Medicine
Volume168
Issue number6
DOIs
StatePublished - Mar 24 2008
Externally publishedYes

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Colonoscopy
African Americans
Colonic Neoplasms
Confidence Intervals
Odds Ratio
Educational Status
Insurance Coverage
Vulnerable Populations
Polyps
Endoscopy
Colon
Cohort Studies
Guidelines

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Murff, H. J., Peterson, N. B., Fowke, J., Hargreaves, M., Signorello, L. B., Dittus, R. S., ... Blot, W. J. (2008). Colonoscopy screening in African Americans and whites with affected first-degree relatives. Archives of Internal Medicine, 168(6), 625-631. https://doi.org/10.1001/archinte.168.6.625

Colonoscopy screening in African Americans and whites with affected first-degree relatives. / Murff, Harvey J.; Peterson, Neeraja B.; Fowke, Jay; Hargreaves, Margaret; Signorello, Lisa B.; Dittus, Robert S.; Zheng, Wei; Blot, William J.

In: Archives of Internal Medicine, Vol. 168, No. 6, 24.03.2008, p. 625-631.

Research output: Contribution to journalArticle

Murff, HJ, Peterson, NB, Fowke, J, Hargreaves, M, Signorello, LB, Dittus, RS, Zheng, W & Blot, WJ 2008, 'Colonoscopy screening in African Americans and whites with affected first-degree relatives', Archives of Internal Medicine, vol. 168, no. 6, pp. 625-631. https://doi.org/10.1001/archinte.168.6.625
Murff, Harvey J. ; Peterson, Neeraja B. ; Fowke, Jay ; Hargreaves, Margaret ; Signorello, Lisa B. ; Dittus, Robert S. ; Zheng, Wei ; Blot, William J. / Colonoscopy screening in African Americans and whites with affected first-degree relatives. In: Archives of Internal Medicine. 2008 ; Vol. 168, No. 6. pp. 625-631.
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AU - Dittus, Robert S.

AU - Zheng, Wei

AU - Blot, William J.

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AB - Background: Family history is a risk factor for colon cancer, and guidelines recommend initiating screening at age 40 years in individuals with affected relatives. Racial differences in colon cancer mortality could be related to variations in screening of increased-risk individuals. Methods: Baseline data from 41 830 participants in the Southern Community Cohort Study were analyzed to determine the proportion of colonoscopy procedures in individuals with strong family histories of colon cancer, and whether differences existed based on race. Results: In participants with multiple affected first-degree relatives (FDRs) or relatives diagnosed before age 50 years, 27.3% (95% confidence interval [CI], 23.5%-31.1%) of African Americans reported having a colonoscopy within the past 5 years compared with 43.1% (95% CI, 37.0%-49.2%) of white participants (P<.001). African Americans in this group had an odds ratio of 0.51 (95% CI, 0.38-0.68) of having undergone recommended screening procedures compared with white participants after adjusting for age, sex, educational status, annual income, insurance status, total number of affected and unaffected FDRs, and time since last medical visit. African Americans with multiple affected FDRs or relatives diagnosed before age 50 years and who had ever undergone endoscopy were less likely to report a personal history of colon polyps (odds ratio,0.29; 95% CI, 0.20-0.42) when compared with whites with similar family histories. Conclusions: African Americans who have FDRs with colon cancer are less likely to undergo colonoscopy screening compared with whites who have affected relatives. Increased efforts need to be directed at identifying and managing underserved populations at increased risk for colon cancer based on their family histories.

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