Primary Care Physicians and Disparities in Colorectal Cancer Screening in the Elderly

Objective

To examine whether having a primary care physician () is associated with reduced ethnic disparities for colorectal cancer () screening and whether clustering of minorities within s contributes to the disparities.

Data Sources/Study Setting

Retrospective cohort study of Medicare beneficiaries age 66–75 in 2009 in Texas.

Study Design

The percentage of beneficiaries up to date in screening in 2009 was stratified by race/ethnicity. Multilevel models were used to study the effect of having a and characteristics on the racial and ethnic disparities on screening.

Data Collection/Extraction Methods

Medicare data from 2000 to 2009 were used to assess prior CRC screening.

Principal Findings

Odds of undergoing screening were more than twice as high in patients with a ( = 2.05, 95 percent 2.03–2.07). After accounting for clustering and characteristics, the black–white disparity in screening rates almost disappears and the Hispanic–white disparity decreases substantially.

Conclusions

Ethnic disparities in screening in the elderly are mostly explained by decreased access to s and by clustering of minorities within s less likely to screen any of their patients.