Public Release:  Racial disparities still exist in colorectal cancer screening despite increased Medicare coverage

American Association for Cancer Research

PHILADELPHIA -- Despite expanded Medicare coverage for colorectal cancer screening tests, lower rates still exist among blacks and Hispanics compared to other ethnic groups, according to research published in Cancer, Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

Researchers from the University of Texas School of Public Health used data from the Surveillance Epidemiology and End Results Program (SEER), a National Cancer Institute database, to determine the prevalence of colorectal cancer screenings among Medicare beneficiaries aged 70 to 89 years with no history of any tumor. Researchers examined the data for an effect of Medicare's expansion of colorectal cancer screening; including coverage of fecal occult blood test, sigmoidoscopy and colonoscopy.

"Colorectal cancer screening increased as Medicare coverage expanded," said Aricia White, Ph.D., an epidemic service officer at the Centers for Disease Control and Prevention. "However, screening rates were still low according to recommendations."

White and colleagues analyzed data from 16 SEER regions of the United States between 1996 and 2005, and found that blacks were less likely than whites to receive colorectal cancer screening before and during Medicare coverage of fecal occult blood test and after coverage of colonoscopy. Hispanics were also less likely to receive screening after colonoscopy coverage.

Electra Paskett, Ph.D., M.P.H., professor in the college of medicine at the Ohio State University and Comprehensive Cancer Center and deputy editor of Cancer, Epidemiology, Biomarkers & Prevention, said this study, like others before it, shows that "we need to make a more concerted effort to make sure that everyone who is eligible to receive these tests gets screened."

"Interventions might need to be focused on the people who are less likely to receive the screening test," she added.

Although there are no follow-up studies planned, this is an area that needs further study.

"While screening rates increased over time, they are still lower than national recommendations," said White. "More efforts need to be made to increase colorectal cancer screening among all beneficiaries."

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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, the AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes 33,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants, research fellowships and career development awards. The AACR Annual Meeting attracts more than 18,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. Including Cancer Discovery, the AACR publishes seven major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. AACR journals represented 20 percent of the market share of total citations in 2009. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists.

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