Racial/Ethnic Differences in Colorectal Cancer Screening in the US

There are well-known racial/ethnic differences in colorectal cancer (CRC) screening in the US. This study aimed to assess whether racial/ethnic differences in CRC screening persisted in 2021 and how demographic and socioeconomic factors contributed to these differences. Population-based study. All adults aged 50 to 75 years in the 2021 National Health Interview Survey were included. The rate of CRC screening was calculated for non-Hispanic White, Black/African American, Hispanic, and Asian individuals. Multivariate logistic regression was used to examine racial/ethnic differences in CRC screening, controlling for age, sex, immigrant status (vs born in the US), college education (vs no college education), and insured status (vs uninsured status). The rate of CRC screening was highest in the non-Hispanic White group (74.4%), followed by the Black/African American (70.9%), Hispanic (61.7%), and Asian (59.5%) groups (P < .01). In multivariate logistic regression, there was no significant racial/ethnic difference in CRC screening after controlling for age (OR, 1.07; 95% CI, 1.06-1.08), female sex (OR, 1.08; 95% CI, 0.997-1.18), immigrant status (OR, 0.62; 95% CI, 0.54-0.70), college education (OR, 1.65; 95% CI, 1.52-1.80), and insured status (OR, 4.38; 95% CI, 3.67-5.23). Sensitivity analysis on colonoscopy use confirmed these findings, except for less colonoscopy use in Asian individuals (OR, 0.73; 95% CI, 0.60-0.89). Racial/ethnic differences in CRC screening in the US were due to differences in demographic and socioeconomic factors, except for persistently low colonoscopy use in Asian individuals.