Statement of the Problem: Elderly individuals are often excluded from bone donation for health reasons or concerns that aging may render a donated organ less suitable for the recipient Also African Americans less likely to find suitable marrow donors leading to fewer transplantations compared to Caucasians.

Methods: Our data source was from a 10-item questionnaire administered as a statewide telephone survey in South Carolina to examine willingness to donate bone marrow. We randomly sampled 421 Caucasians and 408 African Americans (600 responders age 18-55years, 229 responders age >55years).

Results: More than 90% of all respondents were aware that BMT saves lives. We detected no racial or gender differences in reported willingness to donate bone marrow (Caucasians 34%, African Americans 32%, p=0.52; males 32%, females 33%, p=0.61). However, a difference did exist in knowledge (Caucasians 51.3%, African Americans 34.3%, p<0.0001) and reported willingness to sign-up for bone marrow registries (Caucasians 18.3%, African Americans 11%, p=0.0003). African Americans were more aware that better marrow matches are found within the same ethnic group (Caucasians 42.8%, African Americans 61.3%, p<0.0001). No age-by-race interaction, with and without adjusting for other covariates was detected (p=0.19). For both races, younger, more educated respondents knew about the registry and indicated a higher willingness to donate. Ethnic groups shared reasons for unwillingness, with "afraid of pain," the major reason cited. African Americans, however, were more likely to cite "afraid of pain," while Caucasians were more likely to cite "not convenient" and "health problems." Individuals 55 years or older cited "not convenient," "age," and "health problems" more than younger respondents who cited "afraid of pain" more frequently.

Conclusion: Our study suggests reported lack of willingness does not explain the racial disparities in BMT although both races consented less to willingness to be contacted to sign-up especially African Americans, suggesting that actual level of willingness might be confounded by social desirability. Educational measures are needed to improve knowledge for older age groups, especially African Americans. Adequate pain control and education about BMT should improve recruitment of minorities and individuals 55 years and older.

Study completed and published. Dr Onitillo is currently a Hematologist/Oncologist at the Marshfield Clinic in Wisconsin.