Pathways to colonoscopy in the South: Seeds of health disparities

Barbara A. Curbow, Amy B. Dailey, Evelyn C. King-Marshall, Tracey Elaine Barnett, Jessica R. Schumacher, Shahnaz Sultan, Thomas J. George

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objectives. We aimed to highlight sociodemographic differences in how patients access colonoscopy. Methods. We invited all eligible patients (n=2500) from 2 academy-affiliated colonoscopy centers in Alachua County, Florida (1 free standing, 1 hospital based), to participate in a precolonoscopy survey (September 2011-October 2013); patients agreeing to participate (n=1841, response rate =73.6%) received a $5.00 gift card. Results. We found sociodemographic differences in referral pathway, costs, and reasons associated with obtaining the procedure. Patients with the ideal pathway (referred by their regular doctor for age-appropriate screening) were more likely to be Black (compared with other minorities), male, high income, employed, and older. Having the colonoscopy because of symptoms was associated with being female, younger, and having lower income. We found significant differences for 1 previously underestimated barrier, having a spouse to accompany the patient to the procedure. Conclusions. Patients' facilitators and barriers to colonoscopy differed by sociodemographics in our study, which implies that interventions based on a single facilitator will not be effective for all subgroups of a population.

Original languageEnglish
Pages (from-to)e103-e111
JournalAmerican journal of public health
Volume105
Issue number4
DOIs
StatePublished - 1 Apr 2015

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    Curbow, B. A., Dailey, A. B., King-Marshall, E. C., Barnett, T. E., Schumacher, J. R., Sultan, S., & George, T. J. (2015). Pathways to colonoscopy in the South: Seeds of health disparities. American journal of public health, 105(4), e103-e111. https://doi.org/10.2105/AJPH.2014.302347