Black-white Disparities in Colorectal Cancer Incidence, Screening, and Outcomes PDF Download
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Author: Folasade Popoola May
Publisher:
ISBN:
Category :
Languages : en
Pages : 166
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Book Description
African Americans are disproportionately impacted by colorectal cancer (CRC) with higher incidence of disease, higher mortality from disease, and poorer disease survival. These disparities are likely the result of multiple factors, including a high prevalence of CRC risk factors, unfavorable tumor biology, and poor access to medical services among blacks. In addition, while national guidelines promote universal screening for CRC in all Americans, African Americans are less likely than white Americans to pursue screening. There is increasing emphasis in health services research to understand why CRC screening is underutilized in African Americans and to develop interventions that improve screening uptake in the racial subgroup. This dissertation consists of three distinct but related studies that explore black-white disparities in CRC incidence, screening, and outcomes in the United States. The first study evaluates trends in black-white disparities in CRC incidence and stage at diagnosis over the past four decades using the Surveillance, Epidemiology, & End Results (SEER) cancer registry database. Study two is a systematic review of the literature evaluating barriers to colonoscopic CRC screening in African Americans. Study three is a retrospective analysis to compare rates of colonoscopic screening in African Americans and non-African Americans and to identify patient-level, provider-level, and system-level factors associated with receipt and non-receipt of screening in a large Veteran Affairs Healthcare Network. The dissertation demonstrates that while disparities in both CRC incidence and late stage presentation have narrowed over the past four decades, an incidence gap persists. The findings highlight the success of CRC prevention and early detection tools that have come into use over the past three decades and emphasize a continued need for strategies to improve uptake of CRC screening in African Americans. In addition, the dissertation identifies several patient-, provider-, and system-level factors that hinder colonoscopic screening in blacks and contribute to the incidence disparity. While future efforts to address disparities in CRC incidence should focus on increasing the use of screening endoscopy among African Americans to reduce disease incidence, we must not rely on colonoscopic screening alone to decrease the overall burden of CRC on blacks. By determining programs, policy, and interventions to reduce lifestyle risk factors for CRC and optimize use of both preventive and early detection screening methods in varied clinical settings, we can further reduce black-white disparities in CRC incidence, screening, and outcomes.
Author: Folasade Popoola May
Publisher:
ISBN:
Category :
Languages : en
Pages : 166
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Book Description
African Americans are disproportionately impacted by colorectal cancer (CRC) with higher incidence of disease, higher mortality from disease, and poorer disease survival. These disparities are likely the result of multiple factors, including a high prevalence of CRC risk factors, unfavorable tumor biology, and poor access to medical services among blacks. In addition, while national guidelines promote universal screening for CRC in all Americans, African Americans are less likely than white Americans to pursue screening. There is increasing emphasis in health services research to understand why CRC screening is underutilized in African Americans and to develop interventions that improve screening uptake in the racial subgroup. This dissertation consists of three distinct but related studies that explore black-white disparities in CRC incidence, screening, and outcomes in the United States. The first study evaluates trends in black-white disparities in CRC incidence and stage at diagnosis over the past four decades using the Surveillance, Epidemiology, & End Results (SEER) cancer registry database. Study two is a systematic review of the literature evaluating barriers to colonoscopic CRC screening in African Americans. Study three is a retrospective analysis to compare rates of colonoscopic screening in African Americans and non-African Americans and to identify patient-level, provider-level, and system-level factors associated with receipt and non-receipt of screening in a large Veteran Affairs Healthcare Network. The dissertation demonstrates that while disparities in both CRC incidence and late stage presentation have narrowed over the past four decades, an incidence gap persists. The findings highlight the success of CRC prevention and early detection tools that have come into use over the past three decades and emphasize a continued need for strategies to improve uptake of CRC screening in African Americans. In addition, the dissertation identifies several patient-, provider-, and system-level factors that hinder colonoscopic screening in blacks and contribute to the incidence disparity. While future efforts to address disparities in CRC incidence should focus on increasing the use of screening endoscopy among African Americans to reduce disease incidence, we must not rely on colonoscopic screening alone to decrease the overall burden of CRC on blacks. By determining programs, policy, and interventions to reduce lifestyle risk factors for CRC and optimize use of both preventive and early detection screening methods in varied clinical settings, we can further reduce black-white disparities in CRC incidence, screening, and outcomes.
Author: Sohrab Ali
Publisher:
ISBN:
Category : Colon (Anatomy)
Languages : en
Pages : 8
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Book Description
This study examines colorectal cancer incidence and mortality, as well as stage at diagnosis and treatment patterns among whites and African Americans in North Carolina. The results of this study indicate that racial disparities in colorectal cancer incidence and mortality rates persist in North Carolina. African Americans are less likely to receive appropriate screening and less likely to engage in behaviors that reduce the risk of developing or dying from colorectal cancer.
Author: Joseph Anderson, MD
Publisher: Springer Science & Business Media
ISBN: 1607613980
Category : Medical
Languages : en
Pages : 210
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Book Description
Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.
Author: William B. Coleman
Publisher: Humana Press
ISBN: 1597454583
Category : Medical
Languages : en
Pages : 868
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Book Description
This book covers the concepts of molecular medicine and personalized medicine. Subsequent chapters cover the topics of genomics, transcriptomics, epigenomics, and proteomics, as the tools of molecular pathology and foundations of molecular medicine. These chapters are followed by a series of chapters that provide overviews of molecular medicine as applied broadly to neoplastic, genetic, and infectious diseases, as well as a chapter on molecular diagnostics. The volume concludes with a chapter that delves into the promise of molecular medicine in the personalized treatment of patients with complex diseases, along with a discussion of the challenges and obstacles to personalized patient care. The Molecular Basis of Human Cancer, Second Edition, is a valuable resource for oncologists, researchers, and all medical professionals who work with cancer.
Author: John A. Capitman
Publisher: Routledge
ISBN: 1351162101
Category : Social Science
Languages : en
Pages : 406
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Book Description
Originally published in 2005. The prevention, detection and treatment of cancer has received enormous scientific and clinical attention in the US and in other developed countries. However, there has been no comprehensive review of the racial/ethnic disparities in cancer among elders, nor the opportunities for cancer prevention within the Medicare population. In this important work, John A. Capitman, Sarita Bhalotra and Mathilda Ruwe address this deficiency. The evidence report summarized in this book offers systematic syntheses of prior published research and qualitative assessments of emerging approaches in order to illustrate and clarify some of the debates surrounding cancer disparities. Based on a large-scale US government-funded review of existing literature and case studies of model programs by a multidisciplinary team, this key work: * Provides a comprehensive approach to cancer etiology and prevalence among older people; * Integrates genetic, epidemiological, medical care, health services research and social science interpretive frames and current knowledge for cancer control; * Explores existing research on reduction in cancer risks through lifestyle modification and the potential applicability of this research to elders of color; * Explores the implementation experiences of model programs to reduce cancer care inequalities * Develops a conceptual framework of cancer detection and treatment systems across multiple anatomical cancer sites; * Examines opportunities for screening, treatment and follow-up service enhancement for elders of color; * Fills gaps in current published systematic reviews with respect to older people.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030908265X
Category : Medical
Languages : en
Pages : 781
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Book Description
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Author: Ronit Elk
Publisher: Springer Publishing Company
ISBN: 0826108822
Category : Health & Fitness
Languages : en
Pages : 582
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Book Description
There has been remarkable progress in understanding, preventing, detecting, diagnosing, and treating cancer, resulting in a reduction of cancer incidence and mortality in the United States. Despite this, the cancer burden varies considerably by race/ethnicity and socioeconomic status. Cancer incidence rates vary markedly between racial/ethnic groups, but even more startling are the differences in outcome across groups. Cancer Disparities: Causes and Evidence-Based Solutions helps readers understand the scope and causes of this inequity by providing a detailed analysis of the many factors that result in cancer disparities across the cancer continuum, including the role of race/ethnicity, socioeconomic status, access to and use of services, insurance status, geographic variables, and differences in treatment provided to patients. Further, it is the first book to describe evidence-based, concrete solutions that can be used to reduce or even eliminate cancer health disparities. Fifteen previously unpublished studies of interventions designed specifically to achieve health equality are described. These studies focus on contextually and culturally appropriate strategies to enhance cancer prevention, screening and early detection, treatment, symptom management, and quality of life in underserved populations.
Author: Ryan J. Ehrensberger
Publisher:
ISBN:
Category : Colon (Anatomy)
Languages : en
Pages : 242
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Book Description
Despite strong evidence that screening for Colorectal cancer (CRC) can reduce cancer incidence and mortality, screening adherence remains low. Racial differences in CRC incidence and mortality are well documented in the literature. Racial differences in CRC screening use remain mixed with most studies using race as an independent variable and focusing on racial differences in CRC screening rates. Few studies have examined correlates of CRC screening use, stratifying by race. The purpose of this study was to determine if there are racial differences in correlates of CRC screening, using the Health Belief Model as the theoretical framework. Data analyzed in this study came from the 2003 Health Information National Trends Survey (HINTS) of the National Cancer Institute. White (n=1988) and non-white (562) respondents age & [greater or equal] 50 years, without a history of cancer were interviewed by phone. Multivariable logistic regression was used to identify correlates of FOBT and endoscopy adherence stratified by race and screening test. Independent variables included age, gender, education, income, insurance status, regular care visit frequency, perceived risk of CRC, family history of cancer, CRC knowledge, cancer worry, perceptions of screening benefits, and perceptions of expense as a barrier. Predictors of adherence to FOBT for whites included being older and having at least 1 regular car visit. Predictors of FOBT adherence for non-whites included having health insurance. Endoscopy adherence for whites was significantly associated with being older, being female, and agreeing with perceptions of benefits to CRC screening. Predictors of endoscopy adherence for non-whites included being older, and disagreeing with perceptions of benefits to CRC screening. Such differences, if confirmed in future studies, may inform race-specific interventions to increase CRC screening utilization.
Author: Therese A. Dolecek
Publisher:
ISBN:
Category : African Americans
Languages : en
Pages : 120
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Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309178304
Category : Medical
Languages : en
Pages : 128
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Book Description
The IOM's National Cancer Policy Board estimated in 2003 that even modest efforts to implement known tactics for cancer prevention and early detection could result in up to a 29 percent drop in cancer deaths in about 20 years. The IOM's National Cancer Policy Forum, which succeeded the Board after it was disbanded in 2005, continued the Board's work to outline ways to increase screening in the U.S. On February 25 and 26, 2008, the Forum convened a workshop to discuss screening for colorectal cancer. Colorectal cancer screening remains low, despite strong evidence that screening prevents deaths. With the aim to make recommended colorectal cancer screening more widespread, the workshop discussed steps to be taken at the clinic, community, and health system levels. Workshop speakers, representing a broad spectrum of leaders in the field, identified major barriers to increased screening and described strategies to overcome these obstacles. This workshop summary highlights the information presented, as well as the subsequent discussion about actions needed to increase colorectal screening and, ultimately, to prevent more colorectal cancer deaths.
