Distance to endoscopy services amplifies racial inequities in colorectal cancer mortality in Washington state.
Publication Title
American journal of surgery
Document Type
Article
Publication Date
4-18-2024
Keywords
oregon; hood river; diversity
Abstract
BACKGROUND: This study evaluates relationships among race, access to endoscopy services, and colorectal cancer (CRC) mortality in Washington state (WA).
METHODS: We overlayed the locations of ambulatory endoscopy services with place of residence at time of death, using Department of Health data (2011-2018). We compared CRC mortality data within and outside a 10 km buffer from services. We used linear regression to assess the impact of distance and race on age at death while adjusting for gender and education level.
RESULTS: Age at death: median 72.9y vs. 68.2y for white vs. non-white (p < 0.001). The adjusted model showed that non-whites residing outside the buffer died 6.9y younger on average (p < 0.001). Non-whites residing inside the buffer died 5.2y younger on average (p < 0.001), and whites residing outside the buffer died 1.6y younger (p < 0.001). We used heatmaps to geolocate death density.
CONCLUSIONS: Results suggest that geographic access to endoscopy services disproportionately impacts non-whites in Washington. These data help identify communities which may benefit from improved access to alternative colorectal cancer screening methods.
Clinical Institute
Cancer
Clinical Institute
Digestive Health
Specialty
Gastroenterology
Specialty
Oncology
Specialty
Epidemiology
DOI
10.1016/j.amjsurg.2024.04.003
