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Am J Manag Care. 2004 Apr;10(4):273-9.

Health plan policies and programs for colorectal cancer screening: a national profile.

Author information

1
Division of Cancer Control and Population Sciences, National Cancer Institute (NCI), Executive Plaza North Room 4005, 6130 Executive Boulevard, Bethesda, MD 20892-7344, USA. ck97b@nih.gov

Abstract

BACKGROUND:

A consensus has emerged that average-risk adults 50 years of age or older should be screened for colorectal cancer (CRC).

OBJECTIVES:

To describe health plans' coverage policies, guidelines, and organized programs to promote CRC screening.

STUDY DESIGN AND METHODS:

Review of data from the National Cancer Institute Survey of Colorectal Cancer Screening Practices, administered to a national sample of health plans in 1999-2000. The survey inquired about coverage policies for fecal occult blood testing, sigmoidoscopy, colonoscopy, and double-contrast barium enema; the nature of any guidelines the plan had issued to its providers on CRC screening; and systems for recruiting patients into screening and for tracking and reporting the results of screening and follow-up procedures.

RESULTS:

Of 346 eligible health plans, 180 (52%) responded. Nearly all health plans covered at least 1 CRC screening modality. Plans were most likely to cover fecal occult blood testing (97%) and least likely to cover colonoscopy (57%). Sixty-five percent had issued guidelines on CRC screening to providers. One quarter had a mechanism to remind patients that they are due for CRC screening, but fewer had systems for prompting providers, contacting noncompliant patients, or tracking completion of screening.

CONCLUSIONS:

Health plans have the ability to provide organizational infrastructure for a broad range of preventive services to well-defined populations. However, few health plans had all 3 essential CRC screening delivery components--coverage, guidelines, and tracking systems--in place in 1999-2000.

PMID:
15124504
[Indexed for MEDLINE]
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