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    Socioeconomic and racial patterns of colorectal cancer screening among Medicare enrollees in 2000 to 2005

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    Authors
    Doubeni, Chyke A.
    Laiyemo, Adeyinka O.
    Reed, George W.
    Field, Terry S.
    Fletcher, Robert H.
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Medicine, Division of Preventive and Behavorial Medicine
    Department of Family Medicine and Community Health
    Document Type
    Journal Article
    Publication Date
    2009-08-23
    Keywords
    African Continental Ancestry Group
    Aged
    Aged, 80 and over
    Colonoscopy
    Colorectal Neoplasms
    Continental Population Groups
    Cross-Sectional Studies
    European Continental Ancestry Group
    Hispanic Americans
    Humans
    Mass Screening
    Medicare
    *Occult Blood
    *Socioeconomic Factors
    United States
    Health Services Research
    Primary Care
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    Link to Full Text
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018698/pdf/nihms259138.pdf
    Abstract
    BACKGROUND: Lower rates of screening among minorities and low-income populations contribute to colorectal cancer health disparities. Therefore, we examined patterns of colorectal cancer screening and associations with race-ethnicity, education, and income over time. METHODS: Repeated cross-sectional data from the Medicare Current Beneficiary Survey of noninstitutionalized colorectal cancer-free Medicare enrollees ages 65 to 80 years interviewed in 2000 (n = 8,355), 2003 (n = 7,922), and 2005 (n = 7,646). We examined rates of colonoscopy/sigmoidoscopy use within 5 years (recent endoscopy), colonoscopy/sigmoidoscopy use >5 years previously, or fecal occult blood test (FOBT) within 2 years. RESULTS: Among those included in the analyses, there was a steady increase in recent endoscopy rates and decrease in FOBT use over the 6-year period among all racial, educational, and income groups. During each of the survey years, those less educated or in lower-income groups were less likely to undergo colorectal cancer screening in a dose-response fashion. In multinomial regression analyses that adjusted for factors including health insurance, there were no significant differences in recent endoscopy or FOBT rates between Blacks or Hispanics and Whites, but differences by education and income remained. Compared with those in higher-income group, lower-income enrollees had lower rates of screening, and differences by income were larger for enrollees residing in metropolitan areas. CONCLUSION: Among Medicare beneficiaries, there are persistent colorectal cancer screening disparities due to a complex combination of socioeconomic disadvantages from lower education and income, place of residence, and inadequate insurance. However, insurance alone does not eliminate socioeconomic differences in colorectal cancer screening.
    Source
    Cancer Epidemiol Biomarkers Prev. 2009 Aug;18(8):2170-5. Epub 2009 Jul 21. Link to article on publisher's site
    DOI
    10.1158/1055-9965.EPI-09-0104
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37072
    PubMed ID
    19622721
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1158/1055-9965.EPI-09-0104
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