[Frontiers in Bioscience, Landmark, 22, 465-478, January 1, 2017]

Colorectal cancer disparities beyond biology: Screening, treatment, access

Casey L. Daniel 1 , Kelly Gilreath 2 , Danielle Keyes 2

1Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, 36604, 2College of Medicine, University of South Alabama, Mobile, Alabama, 36604

TABLE OF CONTENTS

1. Abstract
2. Introduction
    2.1. Colorectal cancer incidence and mortality in the U.S.
    2.2. Variations by race
3. Is biology to blame?
4. The role of screening
    4.1. Colorectal cancer screening recommendations and methods
    4.2. Uptake of and engagement in screening
    4.3. Interventions designed to decrease barriers and promote screening
5. The health care system and colorectal cancer racial disparities
    5.1. Treatment differences between African American and white patients
    5.2. Variations in quality of and access to care by race
6. African Americans and colorectal cancer: Where do we go from here?
7. References

1. ABSTRACT

African Americans in the United States are more likely than their white counterparts to experience greater incidence and mortality due to colorectal cancer (CRC). Present for decades, these disparities have prompted researchers to investigate underlying causes and potential explanations. While some biological variations have been observed between races, evidence shows that approximately 50% of these disparities can be attributed to differences and disparities in CRC screening, resulting in reduced polyp removal for CRC prevention and/or early detection of CRC among African Americans. Other major contributors to CRC disparities are differences in treatment and access to care. Significant efforts are needed to increase CRC screening among African Americans through targeted interventions to reduce barriers such as increasing education, promoting physician recommendations, and providing affordable and quality care. Intervention is also needed to educate the medical community about these issues and to change health policy to provide a multilevel approach with the best chance of success in reducing racial disparities in CRC.

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Key Words: Colorectal Cancer, Racial Disparity, Screening, Access to Care, Review

Send correspondence to: Casey Daniel, 1660 Springhill Avenue, Mobile, AL 3660, Tel: 251-445-9840, Fax: 251-460-6994, E-mail: cldaniel@health.southalabama.edu