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Colorectal cancer screening behavior and health insurance status (United States)

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Abstract

Objective:The purpose of this study was to examine the association between health insurance status and CRC screening behavior among a diverse sample of ambulatory patients.

Methods: Cross-sectional, retrospective study. Quota sampling techniques were used to recruit 52 insured/uninsured patients ≥age 50 from three Midwestern medical clinics (N=104). Data were collected by interviewer-administered CRC screening questionnaires.

Results: Thirty-nine percent of the sample was in compliance with CRC testing guidelines. Insured compared to uninsured participants were significantly more likely to have ever completed any testing (77% versus 33%), and were more likely to have undertaken testing according to current US guidelines (62% versus 17%), all ps < 0.001. Insured participants also were significantly more likely than the uninsured to know about, receive physician recommendation to screen, and profess future intent to screen, ps < 0.001. Fewer uninsured participants were tested for routine reasons compared to insured participants. Significant group differences did not emerge on future preference for a particular screening methodology, if testing costs were equal.

Conclusions: Results suggest that CRC screening depends, in part, on health insurance status. Increasing insurance coverage or resources for low-cost, accurate tests may facilitate future screening.

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References

  1. National Cancer Institute (2003) HFCA targets the number two cancer killer. Online: http://www.seniors.gov/articles/0301/colorectal_cancer.htm. Accessed 03/01/03

  2. American Cancer Society (2003) Cancer: basic facts, Cancer Facts & Figures 2003, Atlanta, GA: Author, Booklet No. 5008.03

  3. American Cancer Society (2002) Special section: colorectal cancerand early detection, Cancer Facts & Figures 2002. Atlanta, GA: Author, , Booklet 02–250M 5008.02

  4. KS Collins DL Hughes MM Doty BL Ives JN Edwards K Tenney (2002) Diverse communities, common concerns: assessing health care quality for minority Americans Findings from the Commonwealth Fund 2001 Health Care Quality Survey Commonwealth Fund New York

    Google Scholar 

  5. CP Theuer JL Wagner TH Taylor et al. (2001) ArticleTitleRacial and ethnic colorectal cancer patterns affect the cost-effectiveness of colorectal cancer screening in the United States Gastroenterology 120 848–856 Occurrence Handle11231939

    PubMed  Google Scholar 

  6. JG Zapka E Puleo M Vickers-Lahti R Luckmann (2002) ArticleTitleHealthcare system factors and colorectal cancer screening Am J Prev Med 23 28–35 Occurrence Handle10.1016/S0749-3797(02)00444-0 Occurrence Handle12093420

    Article  PubMed  Google Scholar 

  7. InstitutionalAuthorNameInstitute of Medicine (2001) Coverage Matters: Insurance and Health Care National Academy Press Washington

    Google Scholar 

  8. JME Walsh SF Posner EJ Perez-Stable (2002) ArticleTitleColon cancer screening in the ambulatory setting Prev Med 35 209–218 Occurrence Handle10.1006/pmed.2002.1059 Occurrence Handle12202062

    Article  PubMed  Google Scholar 

  9. SH Zuvekas RM Weincik (1999) ArticleTitleChanges in access to care, 1977–1996: the role of health insurance Health Serv Res 34 271–279 Occurrence Handle10199674

    PubMed  Google Scholar 

  10. LA Faulkner HH Schauffler (1997) ArticleTitleThe effect of health insurance coverage on the appropriate use of recommended clinical preventive services Am J Prev Med 19 453–458

    Google Scholar 

  11. JZ Ayanian JS Weissman EC Schneider JA Ginsburg AM Zaslavsky (2000) ArticleTitleUnmet health needs of uninsured adults in the United States JAMA 284 2061–2069 Occurrence Handle10.1001/jama.284.16.2061 Occurrence Handle11042754

    Article  PubMed  Google Scholar 

  12. RT Greenlee MB Hill-Harmon T Murray M Thun (2001) ArticleTitleCancer statistics, 2001 CA: Cancer J Clin 51 15–36

    Google Scholar 

  13. RA Smith AC von Particle Eschenbach R Wender et al. (2001) ArticleTitleAmerican Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal and endometrial cancers CA: Cancer J Clin 51 38–75

    Google Scholar 

  14. SJ Winawer RH Fletcher D Rex et al. (2003) ArticleTitleColorectal cancer screening and surveillance: clinical guidelines and rationale – Update based on new evidence Gastroenterology 124 544–560 Occurrence Handle10.1053/gast.2003.50044 Occurrence Handle12557158

    Article  PubMed  Google Scholar 

  15. JME Walsh JP Terdiman (2002) ArticleTitleColorectal cancer screening: scientific review JAMA 289 1288–1296 Occurrence Handle10.1001/jama.289.10.1288

    Article  Google Scholar 

  16. L Seef M Nadel D Blackman LA Pollack (2003) ArticleTitleColorectal caner test use among persons aged = 50 years – United States JAMA 289 2492–2493 Occurrence Handle10.1001/jama.289.19.2492 Occurrence Handle12759313

    Article  PubMed  Google Scholar 

  17. JE Ware KK Snow M Kosinski B Gandek (1993) SF-36 Health Survey Manual and Interpretation Guide The Health Institute Medical Center Boston, MA

    Google Scholar 

  18. RH Fletcher (2003) ArticleTitleScreening sigmoidoscopy – how often and how good? JAMA 290 106–107 Occurrence Handle10.1001/jama.290.1.106 Occurrence Handle12837719

    Article  PubMed  Google Scholar 

  19. B Thompson GD Coronado CC Solomon DF McClerran ML Neuhouser Z Feng (2002) ArticleTitleCancer prevention behaviors and socioeconomic status among Hispanics and non-Hispanic Whites in a rural population in the United States Cancer Causes Control 13 719–728 Occurrence Handle10.1023/A:1020280427712 Occurrence Handle12420950

    Article  PubMed  Google Scholar 

  20. DH Stockwell P Woo BC Jacobson et al. (2003) ArticleTitleDeterminants of colorectal cancer screening in women undergoing mammography Am J Gastroenterol 98 1875–1880 Occurrence Handle10.1111/j.1572-0241.2003.07577.x Occurrence Handle12907347

    Article  PubMed  Google Scholar 

  21. GA Brenes ED Paskett (2000) ArticleTitlePredictors of stage of adoption for colorectal cancer screening Prev Med 31 410–416 Occurrence Handle10.1006/pmed.2000.0729 Occurrence Handle11006067

    Article  PubMed  Google Scholar 

  22. JME Walsh CP Kaplan B Nguyen G Gildengorin SJ McPhee EJ Perex-Stable (2004) ArticleTitleBarriers to colorectal cancer screening in Latino and Vietnamese Americans compared with non-Latino White Americans J Gen Intern Med 19 156–166 Occurrence Handle10.1111/j.1525-1497.2004.30263.x Occurrence Handle15009795

    Article  PubMed  Google Scholar 

  23. ML Slattery SL Edwards NM Khe GD Friedman (2000) ArticleTitleColon cancer screening, lifestyle, and risk of colon cancer Cancer Causes Control 11 555–563 Occurrence Handle10.1023/A:1008924115604 Occurrence Handle10880038

    Article  PubMed  Google Scholar 

  24. AM Kavanagh EL Giovannucci CS Fuchs GA Colditz (1998) ArticleTitleScreening endoscopy and risk of colorectal cancer in United States men Cancer Causes Control 9 455–462 Occurrence Handle10.1023/A:1008884021049 Occurrence Handle9794179

    Article  PubMed  Google Scholar 

  25. RW Johnson S Crystal (2000) ArticleTitleUninsured status and out-or-pocket costs at midlife Health Serv Res 35 911–932 Occurrence Handle11130804

    PubMed  Google Scholar 

  26. AL Frazier GA Colditz CS Fuchs KM Kuntz (2000) ArticleTitleCost-effectiveness of screening for colorectal cancer in the general populations JAMA 284 1954–1961 Occurrence Handle10.1001/jama.284.15.1954 Occurrence Handle11035892

    Article  PubMed  Google Scholar 

  27. S Manne A Markowitz S Winawer et al. (2002) ArticleTitleCorrelates of colorectal cancer screening compliance and stage of adoption among siblings of individuals with early onset colorectal cancer Health Psychol 21 3–15 Occurrence Handle10.1037//0278-6133.21.1.3 Occurrence Handle11846342

    Article  PubMed  Google Scholar 

  28. J Sudano DW Baker (2003) ArticleTitleIntermittent lack of health insurance coverage and use of preventive services Am J Public Health 93 130–137 Occurrence Handle12511402

    PubMed  Google Scholar 

  29. BA Matthews AB Nattinger AC Ruric (2003) ArticleTitleAccuracy and certainty of self-report for colorectal cancer screening among ambulatory patients Psych Health Med 10 1–15

    Google Scholar 

  30. M Baier N Calonge G Cutter et al. (2000) ArticleTitleValidity of self-reported colorectal cancer screening behavior Cancer Epidemiol Biomarkers Prev 9 229–232 Occurrence Handle10698488

    PubMed  Google Scholar 

  31. NP Gordon RA Hiatt DI Lampert (1993) ArticleTitleConcordance of self-reported data and medical record audit for six cancer screening procedures J Natl Cancer Inst 85 566–570 Occurrence Handle8455203

    PubMed  Google Scholar 

  32. LM Schwartz S Woloshin FJ Fowler HG Welch (2004) ArticleTitleEnthusiasm for cancer screening in the United States JAMA 291 71–78 Occurrence Handle10.1001/jama.291.1.71 Occurrence Handle14709578

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Medical College of Wisconsin, Health Policy Institute, Center for Patient Care and Outcomes Research, Suite H2755, 8701 Watertown Plank Road, 53226--0509, PO Box 26509, Milwaukee, WI, USA

    B. Alex Matthews, Ruric C. Anderson & Ann B. Nattinger

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  1. B. Alex Matthews
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  2. Ruric C. Anderson
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  3. Ann B. Nattinger
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Correspondence to B. Alex Matthews.

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★ This research was supported by a grant funded by the Medical College of Wisconsin Cancer Center.

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Matthews, B.A., Anderson, R.C. & Nattinger, A.B. Colorectal cancer screening behavior and health insurance status (United States). Cancer Causes Control 16, 735–742 (2005). https://doi.org/10.1007/s10552-005-1228-z

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  • DOI: https://doi.org/10.1007/s10552-005-1228-z

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