Negative predictor variables in colorectal cancer screening among Hispanics and white, non-Hispanics

Healthcare disparities are the evolutionary outcome of a fragmented healthcare system involving a complex set of interrelated factors. We studied factors known to be related to disparities in colorectal cancer screening. Data were extracted from the 2001 Behavioral Risk Factor Surveillance System for respondents ages 50 and up specifically involving questions of colorectal cancer screening as well as several common demographic questions. A two-step analytical approach was applied involving chi-square analyses and logistic regression analyses. A total of 87,729 observations were extracted and all of the variables were significant (all p values < 0.05). Logistic regression analyses indicated the main negative predictor for screening with a home fecal occult blood test in the last 2 years (hFOBT2) or a sigmoidoscopy/colonoscopy in the last 10 years (SCOPE) for white, non-Hispanics ages 50--64 was the lack of a primary care physician (PCP) (OR 2.52, 95% CI [2.29--2.79] and OR 2.22 [2.04--2.42], respectively). For Hispanics ages 50--64, the top negative predictor for screening with hFOBT2 was lack of income with the lowest income group having an OR of 10.64 [6.01--18.83]. For screening with a SCOPE, the main negative predictor was lack of a PCP (OR 1.97 [1.50--2.59]). While disparities in colorectal cancer screening are multi-factorial, main negative predictors among the Hispanic population were lack of income and lack of a PCP. For white, non-Hispanics, the main negative predictor was the lack of a PCP.