Perceived racial, sexual discrimination affects cancer screening rates

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Minority men and women who perceived discrimination from their healthcare providers were less likely to be screened for colorectal or breast cancer, according to research in the August issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research (AACR).

“We have yet to achieve bias-free healthcare. This has serious public health implications as we know that higher levels of screening lead to lower levels of mortality. Clinicians need to be aware that they may be sending signals, even unintentionally, that minorities to believe they are being discriminated against,” said lead study author LaVera M. Crawley, MD, MPH, an assistant professor at the Stanford University Center for Biomedical Ethics in Palo Alto, Calif.

Crawley said that exactly what those signals are will need to be determined in future studies, but the relationship between perceived discrimination and failing to get regular screenings is strong.

The researchers analyzed data from the California Health Interview Survey, which examined cancer screening trends among African-American, American-Indian/Alaskan-Native, Asian and Latino adults. The data set included 11,245 respondents.

Crawley noted that the respondents were not asked why they felt discriminated against.

If minority women perceived racial discrimination, the researchers found that they were 34 percent less likely to be screened for colorectal cancer and 48 percent less likely to be screened for breast cancer, compared with women of any racial group who did not perceive discrimination. 

The results were slightly different among minority men. Overall, men who perceived racial discrimination were no less likely to be screened for colorectal cancer than those who did not perceive discrimination, the authors wrote.

However, Crawley and colleagues found that if they had a regular source of healthcare, they were 70 percent less likely to receive colorectal screening if they perceived racial discrimination.

Crawley said that the specific factor would need to be explored in further research, but it may be that there are specific racial stereotypes that apply to men that would not apply to women.

According to Crawley, the consequences for delayed screening are dramatic. If detected early, five-year survival rates for colorectal and breast cancer are approximately 90 percent. However, if caught in later stages, the survival rate for colorectal cancer is 10 percent and 23 percent for breast cancer.