Doctors can improve colorectal cancer screening rates

October 25, 2004

Women and Hispanics are less likely to undergo colorectal cancer (CRC) screening but improving their access to CRC screening may be as simple as educating doctors to make the recommendation and explain its impact to patients, according to a new study. The study will be published in the December 1, 2004 issue of CANCER, a peer-reviewed journal of the American Cancer Society. A free abstract of this study will be available via the CANCER News Room (http://www.interscience.wiley.com/cancer-newsroom) upon online publication.

Colorectal cancer continues to be third leading cause of cancer death among both men and women in the United States. The prognosis is often dependent on stage of disease - that is, a small intestinal polyp carries a better prognosis than a large mass. CRC testing, by fecal occult blood test (FOBT) or endoscopic examination, has been shown to improve prognosis by detecting disease earlier. That's why many health groups recommend CRC screening for men and women over 50 years old. Nevertheless, studies show well under half of Americans 50 and over are getting screened, and disparities are often seen based on race, education and healthcare access.

The study was part of a set of UCLA Center for Health Policy Research studies on cancer screening led by Ninez Ponce, Ph.D., M.P.P., and funded by the National Cancer Institute and The California Endowment. Lead author David Etzioni, M.D., M.S.H.S. of the UCLA School of Medicine and his colleagues used the 2001 California Health Interview Survey1 to investigate the CRC screening habits of 22,343 adults aged 50 and older in California. Their goal was to determine rates of CRC screening, predictors of screening, and reasons why people chose not to undergo CRC screening.

Approximately 54 percent had a recent CRC test, well above the national average. However, two groups appeared less likely to be screened. Latinos, especially women, under 65 years old were less likely to be tested than Caucasians. Latinos and Asians were more likely than Caucasians to report that they did not see a need for screening in the absence of symptoms. Women were less likely to be tested than men and more likely not to be even offered the screening; women also reported that screening was painful or embarrassing. Encouragingly, people who had insurance coverage - public or private - and had continuity of medical care from a usual source predicted a greater likelihood of CRC screening.

The authors conclude that healthcare policies to encourage continuity of care and promote insurance coverage as well as physician and patient education programs on CRC screening guidelines and rationale would improve access to CRC tests.
-end-
1 The 2001 California Health Interview Survey (CHIS 2001) is the largest state population-based health survey in the nation. Administered in several other languages, the Survey includes populations that have been historically excluded from English-only administered population-based surveys. Inclusion of these racial, ethnic and linguistic minorities is particularly important in accurately evaluating the nation's progress in cancer screening. For more information, please visit http://www.chis.ucla.edu.

Article: "A Population-Based Study of Colorectal Cancer Test Use: Results from the 2001 California Health Interview Survey," David A. Etzioni, Ninez A. Ponce, Susan H. Babey, Benjamin A. Spencer, E. Richard Brown, Clifford Y. Ko, Neetu Chawla, Nancy Breen, Carrie N. Klabunde, CANCER; Published Online: October 25, 2004 (DOI: 10.1002/cncr.20692); Print Issue Date: December 1, 2004.

Wiley

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