Racial/ethnic differences in colorectal cancer screening recommendation in the United States in 2021

Background: There were well-known racial/ethnic differences in colorectal cancer (CRC) screening in the United States (US). Aims: To study the rate of CRC screening recommendation for individuals not up-to-date on screening and whether there were racial/ethnic differences in recommendation. Data and Methods: All adults 50 to 75 years old in the 2021 National Health Interview Survey who were not up-to-date on CRC screening were included. The rate of CRC screening recommendation in the past 12 months was calculated for non-Hispanic Whites, Blacks/African Americans, Hispanics, and Asians respectively. Multivariate logistic regression was used to examine racial/ethnic differences in CRC screening recommendation, controlling for demographic and socioeconomic variables (age, sex, immigrant, college education and insured). Results: Among the 3,363 individuals not up-to-date on CRC screening, the rate of CRC screening recommendation was low across all racial/ethnic groups (non-Hispanic Whites 21.6%, Blacks/African Americans 17.8%, Hispanics 12.4%, and Asians 11.2%). Compared with non-Hispanic Whites, CRC screening recommendation was significantly lower for Hispanics and Asians in multivariate logistic regression (Blacks/African Americans: odds ratio [OR] 0.82, 95% confidence interval [CI] 0.62-1.09; Hispanics: OR 0.66, 95% CI 0.47-0.93; Asians: OR 0.53, 95% CI 0.33-0.86), with other predictors including older age and uninsured. Conclusions: The rate of CRC screening recommendation was low for individuals not up-to-date on screening, especially for Hispanics and Asians.