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. 2025 May 5.
doi: 10.1007/s40615-025-02460-3. Online ahead of print.

Chronic Conditions and Racially Biased Healthcare Experiences Impact Breast Cancer and Colorectal Cancer Screening Across Racial/Ethnic Groups

Elinita Pollard  1   2 , Marlo Vernon  1   3 , Samantha Jones  4 , Ara Idun  1 , Avirup Guha  5 , K M Monirul Islam  6 , Meng-Han Tsai  7   8
Affiliations

Chronic Conditions and Racially Biased Healthcare Experiences Impact Breast Cancer and Colorectal Cancer Screening Across Racial/Ethnic Groups

Elinita Pollard et al. J Racial Ethn Health Disparities. .

Abstract

Introduction: Mammogram uptake and colorectal cancer (CRC) screening are influenced by racially biased healthcare experiences and presence of chronic conditions; moreover, there is racially/ethnically disparate uptake of each. The current study aimed to expand on extant literature by examining the association between racially biased healthcare experiences and chronic conditions across three racial/ethnic groups.

Methods: We conducted weighted multivariable logistic regressions to examine the interaction between chronic conditions (none, cancer, other chronic conditions) and racially biased healthcare experiences (none, better, worse, other) on mammogram and CRC screening adherence across three racial/ethnic groups (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic/non-Hispanic Other [NHO]) using 2022 Behavioral Risk Factor Surveillance System data.

Results: Among 42,053 and 86,033 eligible respondents for mammogram and CRC screening, most respondents had an up-to-date mammogram (77.4%) or CRC test (67.0%). In adjusted analysis, Hispanic/NHO respondents with conditions other than cancer and felt they were treated worse than other races while seeking healthcare had a decreased odds of having an up-to-date mammogram (OR 0.21, 95% CI 0.09-0.46). NHW respondents with cancer who felt they were treated better than other races while seeking healthcare had increased odds of having an up-to-date mammogram (OR 1.70, 95% CI 1.11-2.60). All significant associations (i.e., p < 0.05) between chronic conditions and CRC screening were positive, regardless of treatment while seeking healthcare across racial/ethnic groups.

Conclusions: Culturally sensitive interventions aimed at improving patient-centered communication may improve mammogram and CRC screening adherence, particularly for racially/ethnically minoritized groups.

Keywords: Chronic conditions; Colorectal cancer screening; Mammogram; Race/ethnicity; Racially biased healthcare experiences.

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Conflict of interest statement

Declarations. Ethics Approval: The respective health departments from each state grant Institutional Review Board (IRB) approval for the distribution and collection of data using the BRFSS. Data extracted for this study were publicly available and de-identified, and thus considered exempt from IRB review at Augusta University. This article does not include any studies with animals performed by any of the authors. Consent to Participate: Verbal informed consent was obtained from all individual participants included in the study as per the BRFSS process for data collection. Conflict of interest: The authors declare no competing interests. Permission to Reproduce Material: Not applicable. Clinical Trial Registration: There is no clinical trial associated with the current study.

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