Racial/ethnic differences in colorectal cancer screening in the US.

Objectives: There are well-known racial/ethnic differences in colorectal cancer (CRC) screening in the US. This study aimed to assess whether racial/ethnic differences in CRC screening persisted in 2021 and how demographic and socioeconomic factors contributed to these differences.

Study design: Population-based study.

Methods: All adults aged 50 to 75 years in the 2021 National Health Interview Survey were included. The rate of CRC screening was calculated for non-Hispanic White, Black/African American, Hispanic, and Asian individuals. Multivariate logistic regression was used to examine racial/ethnic differences in CRC screening, controlling for age, sex, immigrant status (vs born in the US), college education (vs no college education), and insured status (vs uninsured status).

Results: The rate of CRC screening was highest in the non-Hispanic White group (74.4%), followed by the Black/African American (70.9%), Hispanic (61.7%), and Asian (59.5%) groups (P < .01). In multivariate logistic regression, there was no significant racial/ethnic difference in CRC screening after controlling for age (OR, 1.07; 95% CI, 1.06-1.08), female sex (OR, 1.08; 95% CI, 0.997-1.18), immigrant status (OR, 0.62; 95% CI, 0.54-0.70), college education (OR, 1.65; 95% CI, 1.52-1.80), and insured status (OR, 4.38; 95% CI, 3.67-5.23). Sensitivity analysis on colonoscopy use confirmed these findings, except for less colonoscopy use in Asian individuals (OR, 0.73; 95% CI, 0.60-0.89).

Conclusions: Racial/ethnic differences in CRC screening in the US were due to differences in demographic and socioeconomic factors, except for persistently low colonoscopy use in Asian individuals.