Colon cancer test rates lag
Colon cancer test rates lag
6/11/2013
Although screening rates for colorectal cancer rose from 2002 to 2010, more than a third of at-risk patients were not up to date with screening in 2012, according to a CDC report.
From 2002 to 2010, the proportion of U.S. patients who were up to date with colorectal cancer screening rose from 54% to 65%, according to Djenaba Joseph, MD, of the CDC, and colleagues.
However, as of 2012, that proportion had only risen by 0.1%, and nearly 28% (27.7%) of at-risk patients had never been screened, they wrote online in an early release of Morbidity and Mortality Weekly Report.
Gains in screening were mostly due to increased colonoscopy, as rates of fecal occult blood testing and sigmoidoscopy decreased during that time.
Colorectal cancer represents the second most deadly cancer that is common to men and women overall, and is the leading cause of cancer deaths among non-smokers, noted Thomas Frieden, MD, MPH, director of the CDC, said during a Tuesday conference call.
Frieden cautioned that the largest barrier to patients' screening was that their physician did not recommend any screening, including sigmoidoscopy, fecal occult blood testing, or colonoscopy. He also noted that healthcare professionals could do more to address patients' screening status, such as through outreach, mailers that include fecal occult blood tests, and opening dialogues with patients during healthcare visits.
"The best test is the test that gets done," Frieden emphasized multiple times.
The authors gathered colorectal cancer screening test data through the 2012 Behavioral Risk Factor Surveillance System survey. The survey contained information on 236,565 adult participants' health risk behaviors, preventive health practices, and healthcare access in the U.S.
Participants ages 50 and older were asked whether they had ever used fecal occult blood tests or if they had received a sigmoidoscopy or colonoscopy, and when their last test of that type had occurred. In terms of recommended frequency for each type of test, fecal occult blood tests should be administered annually, while sigmoidoscopy should be performed every 5 years in combination with fecal occult blood tests every 3 years, and colonoscopy should be performed every 10 years.
Prevalence of patients who had never been screened were most common among those ages 50 to 64, males, Hispanics, American Indians and Alaskan Natives, and those in metropolitan areas. Rates of never screening decreased as education and household income increased.
A greater proportion of patients who had never been screened had no insurance (55%) and had no regular care provider (61%) than those who had health insurance (24%) or had a regular care provider (23.5%).
Most patients who were up-to-date with their colorectal cancer screening received colonoscopy (61.7%), followed by fecal occult blood testing (10.4%), and sigmoidoscopy in combination with fecal occult blood testing (0.7%).
There was a positive relationship between household income and being up-to-date with colorectal cancer screening.
They noted that "the potential to increase screening rates exists if healthcare providers identify the test that their patient is most likely to complete and consistently offer all recommended screening," a notion echoed during the conference call: patients who have more options are more likely to have their preferences for screening met.
The authors also cautioned that the study was limited by lack of specifying whether testing was for screening or diagnosis and the resulting over- or underestimates for rates of screening, self-reported data, low response rates to the survey, and lack of cellphone sampling prior to 2011.
Source: MedPage Today: http://www.medpagetoday.com/Gastroenterology/ColonCancer/42750