Racial Disparities Still Exist In Colorectal Cancer Screening Despite Increased Medicare Coverage

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.”