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dc.contributor.authorDoubeni, Chyke A.
dc.contributor.authorLaiyemo, Adeyinka O.
dc.contributor.authorReed, George W.
dc.contributor.authorField, Terry S.
dc.contributor.authorFletcher, Robert H.
dc.date2022-08-11T08:09:23.000
dc.date.accessioned2022-08-23T16:28:41Z
dc.date.available2022-08-23T16:28:41Z
dc.date.issued2009-08-23
dc.date.submitted2011-12-30
dc.identifier.citationCancer Epidemiol Biomarkers Prev. 2009 Aug;18(8):2170-5. Epub 2009 Jul 21. <a href="http://dx.doi.org/10.1158/1055-9965.EPI-09-0104">Link to article on publisher's site</a>
dc.identifier.issn1055-9965 (Linking)
dc.identifier.doi10.1158/1055-9965.EPI-09-0104
dc.identifier.pmid19622721
dc.identifier.urihttp://hdl.handle.net/20.500.14038/37072
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=19622721&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018698/pdf/nihms259138.pdf
dc.subjectAfrican Continental Ancestry Group
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectColonoscopy
dc.subjectColorectal Neoplasms
dc.subjectContinental Population Groups
dc.subjectCross-Sectional Studies
dc.subjectEuropean Continental Ancestry Group
dc.subjectHispanic Americans
dc.subjectHumans
dc.subjectMass Screening
dc.subjectMedicare
dc.subject*Occult Blood
dc.subject*Socioeconomic Factors
dc.subjectUnited States
dc.subjectHealth Services Research
dc.subjectPrimary Care
dc.titleSocioeconomic and racial patterns of colorectal cancer screening among Medicare enrollees in 2000 to 2005
dc.typeJournal Article
dc.source.journaltitleCancer epidemiology, biomarkers and prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
dc.source.volume18
dc.source.issue8
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/meyers_pp/455
dc.identifier.contextkey2426111
html.description.abstract<p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathmeyers_pp/455
dc.contributor.departmentMeyers Primary Care Institute
dc.contributor.departmentDepartment of Medicine, Division of Preventive and Behavorial Medicine
dc.contributor.departmentDepartment of Family Medicine and Community Health
dc.source.pages2170-5


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