Navigation Links
How to prevent disparities in colon cancer screening
Date:6/16/2014

SEATTLEPeople living in poverty are less likely to be screened regularly for colorectal cancerand more likely to develop the disease and die from it. How to end these disparitiesand raise screening rates, lower disease rates, and prevent deaths? A promising way is to mail fecal immunochemical tests (a newer kind of stool test) to populations, Beverly B. Green, MD, MPH, and Gloria D. Coronado, PhD, wrote in the June 17 JAMA Internal Medicine.

Dr. Green is a Group Health physician and an associate investigator at Group Health Research Institute. Dr. Coronado is a senior investigator and the Mitch Greenlick endowed scientist for health disparities at Kaiser Permanente Center for Health Research, in Portland. The journal invited them to write a commentary about a study that David W. Baker, MD, MPH, of Northwestern University led and published in the same issue of the journal.

Drs. Green and Coronado applauded Baker's study for achieving repeat screening rates of more than 82 percent in a largely low-income community. But they were disappointed that only 60 percent of individuals with a positive screening stool test completed follow-up diagnostic colonoscopy. "Lack of a follow-up colonoscopy defeats the purpose of a stool-test screening program," said Dr. Green, who is also an assistant clinical professor at the University of Washington School of Medicine.

Previous studies have shown that when low-income people get colorectal cancer screening, they tend to prefer the option of doing a stool test in the privacy of their own home. But when the test is "positive" (detecting microscopic blood in the stool), people need to get a second test: a follow-up diagnostic colonoscopy. After a positive stool test, nearly a third of people have advanced pre-cancers that can be removed during the follow-up colonoscopyand 4 percent have colorectal cancer.

"For many people, the barriers to receiving the needed follow-up diagnostic colonoscopy include cost," Dr. Green said. For instance, the Affordable Care Act (ACA) mandates full coverage of screening tests that the U.S. Preventive Services Task Force (USPSTF) recommendswith no out-of-pocket expenses. But it covers only the first test that a person choosesa stool test, colonoscopy, or sigmoidoscopynot any follow-up diagnostic testing. That's why Drs. Green and Coronado previously urged that the ACA be amended to cover co-pays for follow-up colonoscopies after a positive stool test or flexible sigmoidoscopy. Otherwise, people who choose those as their first tests could face high, unexpected costs from follow-up testingand existing disparities in screening could worsen.

"On the other hand, most states' Medicaid insurance pays for both stool testing and follow-up colonoscopy, with no out-of-pocket patient costs," Dr. Coronado said. "So disparities in deaths from colorectal cancer could decrease rapidly in those states that have opted into Medicaid expansion."

Dr. Green previously showed in a randomized trial that colorectal cancer screening doubled when Group Health's electronic health record was used in a new way to identify people who needed screening and give them stepped increases in support. And Drs. Green and Coronado showed it was feasible to use a population-based program for mailing stool tests to people in safety-net clinics.


'/>"/>

Contact: Rebecca Hughes
hughes.r@ghc.org
206-287-2055
Group Health Research Institute
Source:Eurekalert  

Related medicine news :

1. UTMB to participate in $30 million national study to prevent falls in older people
2. Antiviral therapy may prevent liver cancer in hepatitis B patients
3. Disinfection caps successful in CLABSI prevention
4. Fatty liver disease prevented in mice
5. Opioid overdose prevention programs may reduce deaths, reports Journal of Addiction Medicine
6. New amyloid-reducing compound could be a preventive measure against Alzheimers
7. Screening has prevented half a million colorectal cancers
8. Surgeons report fewer postoperative blood clots using risk-based preventive measures
9. Diet and exercise in cancer prevention and treatment: Focus of APNM special
10. UC Davis and Orbis partner in telemedicine initiative to treat, prevent blindness
11. Temple-led study finds no benefit in taking statin drugs for COPD exacerbation prevention
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
How to prevent disparities in colon cancer screening
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... Ellevate Network, ... in business to advocate for action towards gender equality at their inaugural Summit in ... around the globe, and reached a social audience of over 3 million. To watch ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, actor Rob ... sciatica in a new episode of "Success Files," which is an award-winning educational ... and investigates each subject in-depth with passion and integrity. , Sciatica occurs when ...
(Date:10/13/2017)... ... 13, 2017 , ... “America On The Brink”: the Christian history of the ... is the creation of published author, William Nowers. Captain Nowers and his wife, ... he spent thirty years in the Navy. Following his career as a naval ...
(Date:10/12/2017)... , ... October 12, 2017 , ... Planet Fitness, one ... U.S., announced today its plans to open a flagship location in Covington, LA at ... former Rooms To Go store next to Office Depot in the Holiday Square shopping ...
(Date:10/12/2017)... ... October 12, 2017 , ... The American College of Medical ... Friedman, PhD, FACMI, during the Opening Session of AMIA’s Annual Symposium in Washington, D.C. ... honor of Morris F. Collen, a pioneer in the field of medical informatics, this ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... 2, 2017 Diplomat Pharmacy, Inc. (NYSE: ... and Consulting, LLC , and named its founder as ... in Tennessee , will operate under ... EnvoyHealth,s service offerings for health care partners to include ... "In an interoperable world, technology delivers ...
(Date:9/28/2017)... 2017 Hill-Rom Holdings, Inc. (NYSE: HRC), will ... and webcast on Friday, November 3, 2017, beginning at ... at approximately 8:30 a.m. (CDT) / 9:30 a.m. (EDT). ... financial performance and guidance for 2018, Hill-Rom executives will ... operational performance, and long-range financial outlook through 2020. ...
(Date:9/25/2017)... PROVIDENCE, R.I. , Sept. 25, 2017 /PRNewswire/ ... immunogenicity assessment, vaccine design, and immune-engineering today announced ... focused on the development of personalized therapeutic cancer ... and has provided exclusive access to enabling technologies ... MSc Eng., MBA will lead EpiVax Oncology as ...
Breaking Medicine Technology: