• Thomas J Semrad, Daniel J Tancredi, Laura-Mae Baldwin, Pamela Green, and Joshua J Fenton.
• Division of Hematology/Oncology, Department of Internal Medicine, University of California Davis Sacramento, California 95817, USA. thomas.semrad@ucdmc.ucdavis.edu
• Cancer. 2011 Apr 15; 117 (8): 1755-63.

BackgroundThe Medicare population has documented racial/ethnic disparities in colorectal cancer (CRC) screening, but it is unknown whether these disparities differ across geographic regions.MethodsAmong Medicare enrollees within 8 US states, we ascertained up-to-date CRC screening on December 31, 2003 (fecal occult blood testing in the prior year or sigmoidoscopy or colonoscopy in the prior 5 years). Logistic regression models tested for regional variation in up-to-date status among white versus different nonwhite populations (blacks, Asian/Pacific Islanders [APIs], Hispanics). We estimated regression-adjusted region-specific prevalence of up-to-date status by race/ethnicity and compared adjusted white versus nonwhite up-to-date prevalence across regions by using generalized least squares regression.ResultsWhite versus nonwhite up-to-date status varied significantly across regions for blacks (P = .01) and APIs (P < .001) but not Hispanics (P = .62). Whereas the white versus black differences in proportion up-to-date were greatest in Atlanta (Georgia), rural Georgia, and the San Francisco Bay Area of California (range, 10%-16% differences, blacksConclusionsSignificant geographic variation in up-to-date status among black and API Medicare enrollees is associated with heterogeneous racial/ethnic disparities for these groups across US regions.Copyright © 2011 American Cancer Society.

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