American Indian/Alaska native access to colorectal cancer screening: Does gastroenterologist density matter?

Journal Article (Journal Article)

BACKGROUND: American Indians/Alaska Natives (AI/AN) receive less colorectal cancer (CRC) screening than other populations. Using gastroenterologist (GI) locations as a measure of colonoscopy access, we correlate GI density and AI/AN CRC screening rates. METHODS: We identified GIs from the 2016 National Provider Identifier registry, and calculated GI density per 100,000 people. We identified screening, demographic, and socioeconomic variables from the 2016 Behavioral Risk Factor Surveillance System Survey. GI density and CRC screening rates were analyzed with Multivariable Poisson regression. RESULTS: In states with GI Density greater than 3.98/100,000, odds of AI/AN CRC screening are 1.27-1.37 times higher than in states below this threshold (p < 0.036). CONCLUSIONS: GI density has a limited association on CRC screening, with decrease impact beyond threshold of 3.98 GI/100,000. Minimal access to GIs is important in improving AI/AN CRC screening; however, further research is required to elucidate the most critical factors contributing to CRC screening.

Full Text

Duke Authors

Cited Authors

  • Gutnik, L; Bleicher, J; Davis, A; McLeod, MC; McCrum, M; Scaife, C

Published Date

  • April 28, 2022

Published In

PubMed ID

  • 35513914

Electronic International Standard Serial Number (EISSN)

  • 1879-1883

Digital Object Identifier (DOI)

  • 10.1016/j.amjsurg.2022.04.023


  • eng

Conference Location

  • United States