Equitable delivery of effective strategies across the screening continuum can increase screening rates and reduce colorectal cancer-related mortality among Black and White individuals, according to a letter to the editor published in the Feb. 24 issue of the New England Journal of Medicine.
Chyke A. Doubeni, M.D., M.P.H., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined the association between participation in colorectal cancer screening and age-standardized incidence rates and mortality from 2000 through 2019. An organized, population-based colorectal cancer screening program was initiated from 2006 to 2008, which used proactive mailed fecal immunochemical testing annually and on-request colonoscopy. The dynamic cohort included 88,734 Black and 703,347 White persons aged 50 to 75 years by 2019.
The researchers found that for Black and White individuals, the percentage of participants who were up to date with screening increased from 42 percent in 2000 to 79 to 80 percent from 2015 to 2019 and from 40 percent in 2000 to 82 to 83 percent from 2015 to 2019, respectively. In both groups, the incidence of early-stage colorectal cancer initially increased, while subsequently, there were decreases observed in both early- and late-stage cancers. Black people had greater initial increases and subsequent decreases. Tandem decreases in colorectal cancer-specific mortality were seen in both groups; the absolute between-group difference in mortality decreased from 21.6 to 1.6 cases per 100,000.
“This study shows how a thoughtful, intentional, coordinated, and sustained approach to delivering care in an equitable manner can eliminate health disparities,” Doubeni said in a statement.
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.
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