Examining racial disparities in colorectal cancer screening and the role of online medical record use: findings from a national survey (Preprint)

Author:

Ewing AldeniseORCID,Marshall Daniel,Tounkara Fode,Henry Abhishek,Abdel-Rasoul Mahmoud,McElwain Skylar,Clark Justice,Tarver Willi,Hefner Jennifer,Zaire Portia,Nolan Timiya,Doubeni Chyke

Abstract

BACKGROUND

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the US. CRC screening can prevent morbidity and mortality. Existing online medical records (OMR) may be underutilized resources to address healthcare access and communication shortcomings.

OBJECTIVE

This study was designed to examine the influence of access to an OMR on CRC screening.

METHODS

In 2023, we conducted a secondary data analysis using a pooled, weighted sample from HINTS 5 Cycles, 2, 3, and 4 (2018-2020). We analyzed the association between sociodemographics, medical conditions, OMR access, and CRC screening via logistic regression.

RESULTS

The sample included adults aged 45-75 years. Mean age was 59 years (SD: 8) for those who reported CRC screening and 52 years (SD: 6) for those never screened. Nearly 70% of participants reported CRC screening and 52% reported OMR access in the past year. Adjusted odds of CRC screening were higher among non-Hispanic Blacks compared to non-Hispanic Whites (OR: 1.76, 95% CI: 1.22 - 2.53), adults who accessed an OMR (OR: 1.89, 95% CI: 1.45 - 2.46), older individuals (OR: 1.18, 95% CI: 1.16 - 1.21), the insured (OR: 3.69, 95% CI: 2.34 - 5.82), and those with a professional or graduate degree vs those with a high school diploma or less (OR: 2.65, 95% CI: 1.28 - 5.47).

CONCLUSIONS

Promoting access to OMRs— especially among the most disadvantaged Americans—may assist in reaching national screening goals. Future research should center tailored and technologically accessible interventions that educate and expand on OMR access.

Publisher

JMIR Publications Inc.

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