A study published by the Journal of the National Cancer Institute found significant racial disparities when it comes to follow-up rates for colonoscopies and the quality of colonoscopy performed.
The study found that Black Americans, who already have higher incidence of colorectal cancer than White Americans, also have lower rates of follow-up colonoscopies for abnormal stool-based tests. Delays in follow up are known to increase CRC incidence, advanced stage at presentation and mortality.
A higher proportion of Black Americans than White Americans receive screening colonoscopies from endoscopists with lower adenoma detection rates, according to the study. Adenoma detection rates are directly associated with the quality of colonoscopy and to better patient outcomes, including the risk of CRC diagnosed between screenings.
The elimination of these disparities could lower CRC incidence and mortality in Black Americans by 5.2% and 9.3%, respectively, the study showed. And closing this gap in quality of colonoscopy being performed for Black versus White Americans would reduce mortality by 9.4%.
The study analyzed publicly available data in the CRC-Adenoma Incidence and Mortality microsimulation model. This model has been used previously to calculate CRC incidence and mortality in the U.S.