Research articleTrends in Colorectal Cancer Test Use in the Medicare Population, 1998–2005
Section snippets
Background
The majority of colorectal cancer (CRC) cases in the U.S. occur in individuals aged ≥60 years, making CRC an important medical condition for the Medicare program.1 Regular screening for CRC is recommended by expert groups.2, 3, 4 Since 1998, Medicare has covered CRC screening for average-risk enrollees aged ≥50 years with four different tests at varying recommended test intervals: fecal occult blood testing (FOBT) every year; sigmoidoscopy every 4 years; barium enema every 5 years; or, for
Methods
In 2000, The Carolinas Center for Medical Excellence (CCME), the quality-improvement organization responsible for Medicare quality of care in North and South Carolina, was asked by the Centers for Medicare & Medicaid Services to develop CRC screening measures and national- and state-level reports of CRC test use in the Medicare population. CCME used enrollment and claims data for the FFS Medicare population in the U.S. to create a web-based report that allows users to obtain estimates of
Results
In 2005, 29 million FFS Medicare aged and disabled enrollees were eligible for CRC testing, an 11.6% increase over the eligible population in 1998 (Table 1). The growth in the population eligible for CRC testing was uneven across demographic groups—the younger enrollee population (aged 50–64 years) increased 50.5% compared to 8.3% for the population aged ≥65 years. In the group aged ≥65 years, greater growth was also seen among men (13.1%) compared to women (5.2%), but an opposite pattern was
Discussion
The results of this study offer both encouraging and discouraging news. It demonstrates that as of 2005, nearly half (47.2%) of Medicare enrollees aged ≥65 years were current with CRC testing as recommended in guidelines. This finding is encouraging because it is substantially higher than in the previous estimate of CRC test compliance based on Medicare claims.15 In that earlier study, data from enrollees aged ≥70 years were analyzed to determine whether individuals had complete screening over
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