The article from HCP Live, authored by Patrick Campbell, highlights significant sex- and race-based disparities in colorectal cancer testing, particularly in diagnostic practices among patients with iron deficiency anemia and/or hematochezia. This analysis is based on data from the Veterans Health Administration, covering a 20-year period from 1999 to 2019.
Key findings from the study include:
Disparities in Diagnostic Testing: The study found that diagnostic testing rates with endoscopy among veterans aged 18 to 49 years with iron deficiency anemia (IDA) and/or hematochezia are low and vary significantly across demographic groups. Notably, Black veterans with IDA and Hispanic veterans with IDA and/or hematochezia were less likely than White veterans to receive diagnostic testing for early age-onset colorectal cancer. Additionally, women with IDA were less likely than men to receive diagnostic testing.
Importance of Early Diagnosis: Colorectal cancer is the second leading cause of cancer-related deaths in the US. Early diagnosis and intervention, especially in cases of early age-onset colorectal cancer (defined as colorectal cancer in adults younger than 50 years), are crucial. Iron deficiency anemia and hematochezia are associated with an increased risk of this cancer type.
Study Methodology: The research, led by Joshua Demb, PhD, MPH, involved analyzing data from the Veterans Health Administration for patients aged 18 to 49 years with a diagnosis of iron deficiency anemia or hematochezia. The primary outcome of interest was the rates of bidirectional endoscopy after a diagnosis of iron deficiency anemia and colonoscopy or sigmoidoscopy after a diagnosis of hematochezia.
Results of the Study: The cumulative 2-year diagnostic workup completion rate was 22% for those with iron deficiency anemia and 40% for those with hematochezia. Women with iron deficiency anemia had a lower likelihood of diagnostic test completion compared to men. Black and Hispanic individuals were also less likely to receive diagnostic testing compared to their non-Hispanic White counterparts.
Implications for Healthcare: The study underscores the need to optimize diagnostic test completion among individuals with iron deficiency anemia and/or hematochezia. This could help improve early detection of early age-onset colorectal cancer and contribute to reducing related disparities.
Overall, the article calls attention to the need for addressing these disparities to ensure more effective and equitable screening and early detection of colorectal cancer.