Background  

Several guidelines recommend initiating colorectal cancer screening at age 40 for individuals with affected first-degree relatives, yet little evidence exists describing how often these individuals receive screening procedures.

Objectives  

To determine the proportion of individuals in whom early initiation of colorectal cancer screening might be indicated and whether screening disparities exist.

Design  

Population-based Supplemental Cancer Control Module to the 2000 National Health Interview Survey.

Participants  

Respondents, 5,564, aged 40 to 49 years were included within the analysis.

Measurements  

Patient self-report of sigmoidoscopy, colonoscopy, or fecal occult blood test.

Results  

Overall, 279 respondents (5.4%: 95% C.I., 4.7, 6.2) reported having a first-degree relative affected with colorectal cancer. For individuals with a positive family history, 67 whites (27.9%: 95% C.I., 21.1, 34.5) and 3 African American (9.3%: 95% C.I., 1.7, 37.9) had undergone an endoscopic procedure within the previous 10 years (P-value = .03). After adjusting for age, family history, gender, educational level, insurance status, and usual source of care, whites were more likely to be current with early initiation endoscopic screening recommendations than African Americans (OR = 1.38: 95% C.I., 1.01, 1.87). Having an affected first-degree relative with colorectal cancer appeared to have a stronger impact on endoscopic screening for whites (OR = 3.21: 95% C.I., 2.31, 4.46) than for African Americans (OR = 1.05: 95% C.I., 0.15, 7.21).

Conclusions  

White participants with a family history are more likely to have endoscopic procedures beginning before age 50 than African Americans.