Low rates still a concern for colorectal screening
While there is some improvement in colorectal cancer screening rates since 2000, still only about half of men and women over age 50 received the recommended screening tests in 2005, according to a report in the July 2008 issue of Cancer Epidemiology, Biomarkers, and Prevention.1
Based on a National Health Interview Survey involving more 30,000 participants, researchers from the Centers for Disease Control and Prevention (CDC) conclude that one of the main contributing factors is lack of insurance coverage. The report points out that the rate of colorectal screening among people without coverage was only 24.1% compared to more than 50% among people with health insurance. Other factors that impacted screening include:
- Education: Only 37% of people with less than a high school education were screened versus 60.7% of college graduates.
- Income: 37.4% of people earning less than $20,000 per year in household income were screened versus 58.5% of those earning at least $75,000.
- Contact with a health care provider: 19.5% of patients who not visited with a physician in the past year were screened versus 52.5% who had seen their physician at least twice in the previous year.
Colorectal cancer screening rates have improved since 2000, when data suggest that only 43% of interview participants reported that they underwent screening. However, the relatively low screening rates are still a concern because screening has been shown to significantly reduce mortality from colon cancer, says the lead author of the report, Jean Shapiro, PhD, an epidemiologist at the CDC. Shapiro points out that colon cancer is the second leading cancer killer, behind only lung cancer, in the United States.
CT colonography (CTC) only recently has been recommended2 along with colonoscopy as a valid colorectal screening procedure, and it is not yet clear whether the recommendation will have a positive impact on screening rates. According to Perry J. Pickhardt, MD, an associate professor of radiology at the University of Wisconsin Medical School in Madison, "A national impact will probably take time, and won't occur until reimbursement from third-party payers is seen at the national level, [probably] in 6-12 months." Pickhardt is also a co-author of new guidelines on colorectal screening issued by the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology (ACR).2
References
- Shapiro J, Seeff L, Thompson T, et al. Colorectal cancer test use from the 2005 National Health Interview Survey. Cancer Epidemiology, Biomarkers, and Prevention 2008; 17:1,623-1,630.
- Levin B, Lieberman D, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, The US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA A Cancer Journal for Clinicians 2008; 58:130-160.
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