African Americans should be screened at an earlier age for XXXX .

@entity1 @entity694 @entity159 @entity14
BACKGROUND: African Americans (AAs) have been shown to exhibit a higher incidence of @entity14 and experience lower survival compared with whites. There is disagreement regarding the age at which to initiate screening in AAs. OBJECTIVES: To calculate the age-specific incidence in AAs compared with whites while controlling for differences in @entity159 ( @entity159 ) and to calculate the joinpoint at which the incidence begins to increase in each race. DESIGN: Retrospective database review. SETTING: Surveillance, Epidemiology, and End Results database. @entity1 : All @entity1 with @entity694 or rectum from 2000 through 2011 in the SEER 18 database. INTERVENTIONS: We calculated the joinpoint of the upward trend of the age-adjusted incidence rate to determine the age at which the slope of the incidence curve began to increase in each race, while controlling for differences in @entity159 by using a composite socioeconomic index. MAIN OUTCOME MEASUREMENTS: Age-adjusted incidence of @entity694 . RESULTS: The age-specific incidence of @entity14 (cases per 100,000 population) was 0.3 versus 0.4 in whites compared with AAs at 20 years of age. At 50 years of age, the incidence was 44.2 compared with 62.6 in whites compared with AAs. The model indicated a joinpoint at 47 years of age for whites (95% confidence interval, 45-49) and 43 for AAs (95% confidence interval, 42-45) (P  < .001.) When @entity159 was considered in stratification, joinpoints for whites were 48, 47, and 46 at high, middle, and low @entity159 , respectively. Conversely, joinpoints of 43, 44, and 42 in the corresponding @entity159 for AAs were noted (P   <= .001). LIMITATIONS: There was no intervention, and we cannot conclude that changing screening policy would affect this disparity. CONCLUSION: There is a disparity in the age-specific incidence of @entity14 in AAs compared with whites beginning at 45 years of age. These differences persist across socioeconomic strata.
