Abstract
Objective
Colorectal cancer screening allows for both prevention and early detection of the disease, with early detection often resulting in improved prognosis. Too few Americans over 50 are screened for colorectal cancer, but among certain subpopulations screening rates are particularly low for various reasons. We examined the role of communication factors and insurance, with a specific focus on the uninsured to examine disparities in colorectal cancer screening.
Methods
We used Health Information National Trends Survey data to examine: disparities in colorectal cancer screening, by calculating proportions of subpopulations screened; and the association between communication and screening among the uninsured, by performing chi-square tests and simple logistic regression to examine the potential factors associated with screening.
Results
The uninsured were 64% less likely to be screened than the insured. Provider recommendation was the only significant communication measure, with the uninsured lacking a recommendation 98.5% less likely to be screened than those with one.
Conclusion
These data suggest expansion of programs of screening among the uninsured and more aggressive communication campaigns to promote the awareness and provider recommendation of screening as possible ways to increase screening and reduce mortality of colorectal cancer.
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Notes
It is worth noting that 33.3% of the uninsured had not heard of the tests, and therefore had a low level of awareness. In comparison, 24.6% of the insured had not heard of the tests.
CAHPS are overseen by the Agency for Health Care Policy and Research and are used as tools for quality assessment.
Kendall’s tau-b is a rank correlation coefficient used to assess the relationship between two ordinal variables. We used this test for variables with more than two categories in a natural order.
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Acknowledgements
The authors wish to acknowledge the valuable assistance and insights of Paula Minihan, Elena Naumova, Mark Woodin, and Paul Hattis.
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Cairns, C.P., Viswanath, K. Communication and colorectal cancer screening among the uninsured: data from the Health Information National Trends Survey (United States). Cancer Causes Control 17, 1115–1125 (2006). https://doi.org/10.1007/s10552-006-0046-2
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DOI: https://doi.org/10.1007/s10552-006-0046-2