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Recent Studies Reveal Underuse of Colorectal Screenings, Late Stage Cancer Diagnoses

An analysis published in ACS' journal CANCER in January 2008 of over 150,000 Medicare beneficiaries revealed that only 25 percent received recommended screenings for colorectal cancer since Medicare started to cover preventive screening tests. This finding reflects a significant underuse of proven screening tests among Medicare patients, and echoes other recent findings that Medicaid patients and the uninsured generally are being diagnosed with colorectal cancer at later stages, when the prognosis is far worse.

A study by Halpern et al. published in The Lancet Oncology on February 18, 2008 found a correlation between insurance status and stage of cancer diagnosis. According to the Halpern analysis, uninsured patients were two to three times more likely to be diagnosed at late stages (Stage III or State IV) than at Stage I. The disparity was most pronounced among cancers that could be detected early through screening or symptom assessment including colorectal cancer. The analysis also looked at racial background and found late state diagnosis for ten of twelve cancers among African Americans compared to whites.

ACG Recommends Earlier Screening for African-Americans: Begin at Age 45

African-Americans are diagnosed with colorectal cancer at a younger age than other ethnic groups, and African-Americans with colorectal cancer have decreased survival compared with other ethnic groups. Physician experts from the American College of Gastroenterology in 2005 issued new recommendations to healthcare providers to begin colorectal cancer screening in African-Americans at age 45 rather than 50. Colonoscopy is the preferred method of screening for colorectal cancer and data support the recommendation that African-Americans begin screening at a younger age because of the high incidence of colorectal cancer and a greater prevalence of proxi
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