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J Am Geriatr Soc. 2009 Mar;57(3):412-8. doi: 10.1111/j.1532-5415.2008.02143.x. Epub 2009 Jan 16.

Persistent racial and ethnic disparities in up-to-date colorectal cancer testing in medicare enrollees.

Author information

  • 1Department of Family and Community Medicine, School of Medicine, University of California, Davis, Sacramento, California 95817, USA. Joshua.fenton@ucdmc.ucdavis.edu

Abstract

OBJECTIVES:

To assess whether greater colonoscopy use among white as compared with nonwhite Medicare enrollees since Medicare established coverage for colorectal cancer (CRC) screening has been associated with a widening in white versus nonwhite disparities in up-to-date CRC testing status.

DESIGN:

Serial cross-sectional analysis of Medicare claims.

SETTING:

Surveillance, Epidemiology, and End Results (SEER) regions in nine states, representing 14% of the U.S. population.

PARTICIPANTS:

A 5% random sample of fee-for-service Medicare enrollees aged 70 to 79 within each 6-month period from mid-1995 through 2003.

MEASUREMENTS:

Trends in up-to-date status (having a fecal occult blood test (FOBT) claim in the prior year or a sigmoidoscopy or colonoscopy claim in the prior 5 years) according to race or ethnicity, estimated using repeated-measures logistic regression adjusting for age, sex, rural versus urban residence, income, comorbidity, and SEER region.

RESULTS:

From mid-1995 through 2003, the adjusted percentage of enrollees that were up-to-date increased by a similar magnitude in whites (from 39.4% to 47.3%), blacks (from 29.0% to 38.1%), Asians and Pacific Islanders (from 33.1% to 41.8%), and Hispanics (from 23.7% to 33.2%). Although white versus nonwhite disparities in up-to-date status via colonoscopy widened, this was counterbalanced by narrowing white versus nonwhite disparities in up-to-date status via FOBT and sigmoidoscopy.

CONCLUSION:

White versus nonwhite disparities in up-to-date CRC testing status in Medicare enrollees largely persisted through 2003.

PMID:
19175435
[PubMed - indexed for MEDLINE]
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