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No insurance? No colonoscopy
May 08, 2009John M Inadomi highlights the disparity in colorectal cancer screening (CRCS) among different socioeconomic and ethnic groups in US society in a recent review published by F1000 Medicine Reports (www.f1000medicine.com/reports).
Colorectal cancer is the second leading cause of cancer-related death in the developed world. In this report, John Inadomi, chief of Clinical Gastroenterology at the San Francisco General Hospital and a frequent contributor to F1000 Medicine, writes that the uptake of certain types of screening has been linked to inadequate medical insurance amongst the poorer socio-economic and ethnic groups.
Of the several screening modalities currently available, colonoscopy, sigmoidoscopy and fecal occult blood testing (FOBT) have been shown to reduce colorectal cancer incidence or mortality. Inadomi draws attention to the high prevalence of 'flat' colonic lesions since some screening methods are less likely to detect flat lesions, patients who opt for these modalities (e.g. for financial reasons) could be at risk of lesions being missed.
One study cited in Inadomi's report found that "African-American women were half as likely as white women to report having undergone screening by colonoscopy." Added to this, awareness of the different tests for CRCS was significantly lower among African-Americans than whites. Correspondingly, there was a similar significant difference in lack of medical insurance coverage between these groups.
New technologies used in rural primary care practice to educate people to different types of CRCS have proven to raise the number of patient intention to get screened, helping to overcome socio-economic barriers.
While recognising that language, culture and economic inequality remain significant barriers, Inadomi is optimistic about "the use of new technology and techniques for disseminating information among patients and their providers", and concludes that the efficacy of CRCS may be better improved by "specific educational interventions" than by any given advance in current screening technologies.
Faculty of 1000: Biology and Medicine
One study cited in Inadomi's report found that "African-American women were half as likely as white women to report having undergone screening by colonoscopy." Added to this, awareness of the different tests for CRCS was significantly lower among African-Americans than whites. Correspondingly, there was a similar significant difference in lack of medical insurance coverage between these groups.
New technologies used in rural primary care practice to educate people to different types of CRCS have proven to raise the number of patient intention to get screened, helping to overcome socio-economic barriers.
While recognising that language, culture and economic inequality remain significant barriers, Inadomi is optimistic about "the use of new technology and techniques for disseminating information among patients and their providers", and concludes that the efficacy of CRCS may be better improved by "specific educational interventions" than by any given advance in current screening technologies.
Faculty of 1000: Biology and Medicine
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Adding cetuximab to chemotherapy reduces advanced lung cancer death risk by 13 percent
Patients with advanced non-small cell lung cancer who are given cetuximab (Erbitux) in addition to chemotherapy are 13% less likely to die than those who receive chemotherapy alone, regardless of which chemotherapy drug cocktail is used, new research finds. They also experience slower disease progression and an increased chance of tumour shrinkage.
New blood tests promise simple, cost-effective diagnosis of gastrointestinal cancers
Promising results from two new blood tests that can aid in the early identification of patients with gastrointestinal (GI) cancers will be presented at Europe's largest cancer congress.
University of Hawaii at Manoa CRCH scientists report adulthood body size associated with cancer risk
A team of scientists led by researcher Brenda Hernandez, Ph.D., M.P.H.-an assistant professor at the University of Hawai'i at Mānoa's Cancer Research Center of Hawai'i-has reported that body mass in younger and older adulthood, and weight gain between these life periods, may influence a man's risk for prostate cancer.
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