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Li S, Miller-Wilson LA, Guo H, Fisher DA. Adherence to colorectal cancer screening and healthcare resource utilization: a longitudinal analysis in Medicare beneficiaries aged 66-75 years. Curr Med Res Opin 2022; 38:2201-2208. [PMID: 36205707 DOI: 10.1080/03007995.2022.2133493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In this study, we examined colorectal cancer (CRC) screening adherence in Medicare beneficiaries and associated healthcare resource utilization (HCRU) and Medicare costs. METHODS Using 20% Medicare random sample data, the study population included Medicare fee-for-service beneficiaries aged 66-75 years on 1 January 2009, at average risk for CRC and continuously enrolled in Medicare Part A/B from 2008 to 2018. We excluded those who had undergone colonoscopy or flexible sigmoidoscopy during 2007-2008 and assumed everyone was due for screening in 2009; screening patterns were determined for 2009-2018. Based on US Preventive Services Task Force recommendations, individuals were categorized as adherent to screening, inadequately screened or not screened. HCRU and Medicare costs were calculated as mean per patient per year (PPPY). RESULTS Of 895,846 eligible individuals, 13.2% were adherent to screening, 53.4% were inadequately screened, and 33.4% were not screened. Compared with those not screened, adherent or inadequately screened individuals were more likely to be female, White and have comorbidities. These individuals also used more healthcare services, generating higher Medicare costs. For example, physician visits were 14.6, 22.9 and 25.9 PPPY and total Medicare costs were $6102, $8469 and $9102 PPPY for those not screened, inadequately screened and adherent, respectively. CONCLUSIONS In Medicare beneficiaries at average risk, adherence to CRC screening was low, although the rate might be underestimated due to lack of early Medicare data. The link between HCRU and screening status suggests that screening initiatives independent of clinical visits may be needed to reach unscreened or inadequately screened individuals.
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Affiliation(s)
- Suying Li
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | | | - Haifeng Guo
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
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Li S, Miller-Wilson LA, Guo H, Hoover M, Fisher DA. Incident colorectal cancer screening and associated healthcare resource utilization and Medicare cost among Medicare beneficiaries aged 66-75 years in 2016-2018. BMC Health Serv Res 2022; 22:1228. [PMID: 36192728 PMCID: PMC9531423 DOI: 10.1186/s12913-022-08617-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/29/2022] [Indexed: 11/12/2022] Open
Abstract
Background While prevalence of up-to-date screening status is the usual reported statistic, annual screening incidence may better reflect current clinical practices and is more actionable. Our main purpose was to examine incident colorectal cancer (CRC) screening rates in Medicare beneficiaries and to explore characteristics associated with CRC screening. Methods Using 20% Medicare random sample data, the study population included 2016–2018 Medicare fee-for-service beneficiaries covered by Parts A and B aged 66–75 years at average CRC risk. For each study year, we excluded individuals who had a Medicare claim for a colonoscopy within 9 years, flexible sigmoidoscopy within 4 years, and multitarget stool DNA test (mt-sDNA) within 2 years prior; therefore, any observed screening during study year was considered an “incident screening”. Incident screening rates were calculated as number of incident screenings per 1000 Medicare beneficiaries. Overall rates were normalized to 2018 Medicare population distributions of age, sex, and race. Results Each year, > 1.4 million individuals met the inclusion/exclusion criteria from > 6.5 million Medicare beneficiaries. The overall adjusted incident CRC screening rate per 1000 Medicare beneficiaries increased from 85.2 in 2016 to 94.3 in 2018. Incident screening rates decreased 11.4% (22.9 to 20.3) for colonoscopy and 2.4% (58.3 to 56.9) for fecal immunochemical test/guaiac-based fecal occult blood test; they increased 201.5% (6.5 to 19.6) for mt-sDNA. The 2018 unadjusted rate was 76.0 for men and 110.4 for women. By race/ethnicity, the highest 2018 rate was for Asian individuals and the lowest rate was for Black individuals (113.4 and 72.8, respectively). Conclusions The 2016–2018 observed incident CRC screening rate in average-risk Medicare beneficiaries, while increasing, was still low. Our findings suggest more work is needed to improve CRC screening overall and, especially, among male and Black Medicare beneficiaries. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08617-8.
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Affiliation(s)
- Suying Li
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, 701 Park Avenue, Suite S2.100, Minneapolis, MN, 55415, USA.
| | | | - Haifeng Guo
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, 701 Park Avenue, Suite S2.100, Minneapolis, MN, 55415, USA
| | - Madison Hoover
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, 701 Park Avenue, Suite S2.100, Minneapolis, MN, 55415, USA
| | - Deborah A Fisher
- Department of Medicine and Duke Clinical Research Institute, Duke University, Durham, NC, USA
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3
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Soroudi C, Mafi J, Myint A, Gardner J, Kahlon S, Mongare M, Yang L, Tseng CH, Reynolds C, Nair V, Villaflores C, Cates R, Gupta R, Sarkisian C, May FP. Leveraging Electronic Health Records to Measure Low-Value Screening Colonoscopy. Am J Med 2022; 135:715-720.e2. [PMID: 35219690 PMCID: PMC10176807 DOI: 10.1016/j.amjmed.2021.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Camille Soroudi
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - John Mafi
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles; Division of Health Services Research, David Geffen School of Medicine, University of California, Los Angeles
| | - Anthony Myint
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Juliana Gardner
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Sartajdeep Kahlon
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Margaret Mongare
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Liu Yang
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Chi-Hong Tseng
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Courtney Reynolds
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Vishnu Nair
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Chad Villaflores
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Reinalyn Cates
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Reshma Gupta
- University of California Health, University of California Davis Medical Center, Sacramento
| | - Catherine Sarkisian
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles; VA Greater Los Angeles Healthcare System Geriatrics Research Education & Clinical Center (GRECC), Los Angeles, Calif
| | - Folasade P May
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles; Division of Gastroenterology, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, Calif; UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, Los Angeles, Calif.
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4
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Zhao L, Zhang X, Chen Y, Wang Y, Zhang W, Lu W. Does self-reported symptom questionnaire play a role in nonadherence to colonoscopy for risk-increased population in the Tianjin colorectal cancer screening programme? BMC Gastroenterol 2021; 21:117. [PMID: 33750307 PMCID: PMC7944887 DOI: 10.1186/s12876-021-01701-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/28/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A colorectal cancer screening programme (CCSP) was implemented from 2012 to 2017 in Tianjin, China. Residents with a positive faecal immunochemical test (FIT) or positive self-reported symptom questionnaire (SRSQ) were recommended to undergo colonoscopy. The objective was to investigate the potential factors associated with nonadherence to colonoscopy among a risk-increased population. METHODS Data were obtained from the CCSP database, and 199,522 residents with positive FIT or positive SRSQ during two screening rounds (2012-2017) were included in the analysis. Logistic regression analysis was performed to assess the association between nonadherence to colonoscopy and potential predictors. RESULTS A total of 152,870 (76.6%) individuals did not undergo colonoscopy after positive FIT or positive SRSQ. Residents with positive SRSQ but without positive FIT were more likely not to undergo colonoscopy (negative FIT: OR, 2.35; 95% CI, 2.29-2.41, no FIT: OR, 1.27; 95% CI, 1.24-1.31). Patients without a cancer history were less likely to undergo colonoscopy even if they received risk-increased reports based on the SRSQ. CONCLUSION In the CCSP, seventy-seven percent of the risk-increased population did not undergo colonoscopy. FIT should be recommended since positive FIT results are related to improved adherence to colonoscopy. Residents with negative FIT but positive SRSQ should be informed of the potential cancer risk to ensure adherence to colonoscopy.
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Affiliation(s)
- Lizhong Zhao
- Department of Gastroenterology, Tianjin Union Medical Center, Tianjin, China
| | - Xiaorui Zhang
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - Yuan Wang
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - Weihua Zhang
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China.
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Preen DB, Lansdorp-Vogelaar I, Ee HC, Platell C, Cenin DR, Troeung L, Bulsara M, O'Leary P. Optimizing Patient Risk Stratification for Colonoscopy Screening and Surveillance of Colorectal Cancer: The Role for Linked Data. Front Public Health 2017; 5:234. [PMID: 28944221 PMCID: PMC5596072 DOI: 10.3389/fpubh.2017.00234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 08/18/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
- David B Preen
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | | | - Hooi C Ee
- Department of Gastroenterology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Cameron Platell
- Colorectal Cancer Research Unit, The University of Western Australia, Perth, WA, Australia
| | - Dayna R Cenin
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.,Department of Public Health, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Lakkhina Troeung
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Max Bulsara
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.,Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia
| | - Peter O'Leary
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the current state of endoscopic quality measurement and use of measures in enhancing the value of endoscopic services. RECENT FINDINGS Initially, quality measurement of endoscopic procedures was claims based or included small unit or practice-specific efforts. Now we have a mature national registry and large electronic medical or procedural records that are designed to yield valuable data relevant to quality measurement. SUMMARY With the advent of better measures, we are beginning to understand that initial process and surrogate outcome measures (adenoma detection rate) can be improved to provide a better reflection of endoscopic quality. Importantly, however, even measures currently in use relate to important patient outcomes such as missed colon cancers. At a federal level, older cumbersome pay-for-performance initiatives have been combined into a new overarching program named the quality payment program within the centers for medicare and medicaid services. This program is an additional step toward furthering the progress from volume-to-value-based reimbursement. The legislation mandating the movement toward outcomes-linked (value) reimbursement is the medicare access and children's health insurance program reauthorization act, which was passed with overwhelming bipartisan support and will not be walked back by alterations of the affordable care act. Increasing portions of medicare reimbursement (and likely commercial to follow) will be linked to quality metrics, so familiarity with the underlying process and rationale will be important for all proceduralists.
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Keating NL, James O’Malley A, Onnela JP, Landon BE. Assessing the impact of colonoscopy complications on use of colonoscopy among primary care physicians and other connected physicians: an observational study of older Americans. BMJ Open 2017; 7:e014239. [PMID: 28645954 PMCID: PMC5623374 DOI: 10.1136/bmjopen-2016-014239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Psychological biases can distort treatment decision-making. The availability heuristic is one such bias, wherein events that are recent, vivid or easily imagined are readily 'available' to memory and are therefore judged more likely to occur than expected based on epidemiological data. We assessed if the occurrence of a serious colonoscopy complication for a primary care physician's patient influenced colonoscopy rates for the physician's other patients. DESIGN Longitudinal study with time-varying exposure variables. SETTING/PARTICIPANTS Individuals living in 51 hospital referral regions across the USA identified based on enrolment in fee-for-service Medicare during 2005-2010. We assigned patients to a primary care physician based on office visits during the prior 2 years. EXPOSURES For each physician in each month, we calculated the proportion of patients assigned to them who had a colonoscopy. We identified two serious complications of which the primary care provider would very likely be aware: gastrointestinal bleed or perforation leading to hospitalisation or death within 14 days of colonoscopy. MAIN OUTCOME MEASURES We employed Poisson regression models including physician fixed effects to assess the change in number of colonoscopies in the four quarters following an adverse colonoscopy event. RESULTS We identified 5 360 191 patients assigned to 30 704 physicians. 4864 physicians (16%) had at least one patient with an adverse event. The estimated change in the quarterly number of colonoscopies among physicians' patients was significantly lower in quarter 2 following an adverse colonoscopy event (change=-2.1% (95% CI -3.4 to -0.8%)), before returning to the rate expected in the absence of an adverse event. CONCLUSIONS Having a patient experience a serious adverse colonoscopy event was associated with a small and temporary decline in colonoscopy rates among a physician's other patients. This finding provides empirical evidence for the influence of notable adverse events on care, possibly due to the availability heuristic.
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Affiliation(s)
- Nancy L Keating
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
- Division of General Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - A James O’Malley
- The Department of Biomedical Data Science, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, Massachusetts, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H Chan School of Public Health, Boston, Massachusetts, USA
| | - Bruce E Landon
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
- Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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8
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Bian J, Chen B, Hershman DL, Marks N, Norris L, Schulz R, Bennett CL. Effects of the US Food and Drug Administration Boxed Warning of Erythropoietin-Stimulating Agents on Utilization and Adverse Outcome. J Clin Oncol 2017; 35:1945-1951. [PMID: 28441110 DOI: 10.1200/jco.2017.72.6273] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Purpose In March 2007, a US Food and Drug Administration boxed warning was issued for erythropoietin-stimulating agents (ESAs) regarding serious adverse events, such as venous thromboembolism (VTE). We evaluated the US Food and Drug Administration's boxed warning of ESAs used to treat chemotherapy-induced anemia because evidence on the effectiveness of boxed warnings remains inconclusive. Patients and Methods Using 2004 to 2009 SEER-Medicare data, we exploited a natural experiment to examine the effects of ESA boxed warnings on utilization and risk of VTE. The intervention group included Medicare fee-for-services patients diagnosed with colorectal, breast, or lung cancers targeted by this warning and undergoing chemotherapy; the control group included patients with myelodysplastic syndromes not targeted by this warning. The period from January 2004 to September 2006 was used as the prewarning period; the period from April 2007 to September 2009 was used as the postwarning period. The two binary dependent variables included ESA use and hospitalized VTE. Linear probability models with a difference-in-differences specification were used for estimation. Results Our sample consisted of 45,319 unique patients between 2004 and 2009. The trends in ESA use remained similar between the intervention and control groups before the warning, but started declining sharply in the intervention group only after the warning. The trends in hospitalized VTE were relatively stable. Regressions showed that the ESA boxed warning was associated with a 20.2-percentage-point reduction ( P < .001) in the likelihood of ESAs being used to treat cancers targeted by the warning, but not significantly associated with the likelihood of hospitalized VTE. Conclusion Our study showed that the warning was effective in reducing ESA utilization. Future studies should examine other regulatory drug safety actions, such as the Risk Evaluation and Mitigation Strategy initiative, whose effectiveness remains unknown.
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Affiliation(s)
- John Bian
- John Bian, LeAnn Norris, Richard Schulz, and Charles L. Bennett, University of South Carolina College of Pharmacy; Brian Chen, University of South Carolina, Columbia, SC; Dawn L. Hershman, Columbia University, New York, NY; and Norman Marks, Medical Product Place, Gaithersburg, MD
| | - Brian Chen
- John Bian, LeAnn Norris, Richard Schulz, and Charles L. Bennett, University of South Carolina College of Pharmacy; Brian Chen, University of South Carolina, Columbia, SC; Dawn L. Hershman, Columbia University, New York, NY; and Norman Marks, Medical Product Place, Gaithersburg, MD
| | - Dawn L Hershman
- John Bian, LeAnn Norris, Richard Schulz, and Charles L. Bennett, University of South Carolina College of Pharmacy; Brian Chen, University of South Carolina, Columbia, SC; Dawn L. Hershman, Columbia University, New York, NY; and Norman Marks, Medical Product Place, Gaithersburg, MD
| | - Norman Marks
- John Bian, LeAnn Norris, Richard Schulz, and Charles L. Bennett, University of South Carolina College of Pharmacy; Brian Chen, University of South Carolina, Columbia, SC; Dawn L. Hershman, Columbia University, New York, NY; and Norman Marks, Medical Product Place, Gaithersburg, MD
| | - LeAnn Norris
- John Bian, LeAnn Norris, Richard Schulz, and Charles L. Bennett, University of South Carolina College of Pharmacy; Brian Chen, University of South Carolina, Columbia, SC; Dawn L. Hershman, Columbia University, New York, NY; and Norman Marks, Medical Product Place, Gaithersburg, MD
| | - Richard Schulz
- John Bian, LeAnn Norris, Richard Schulz, and Charles L. Bennett, University of South Carolina College of Pharmacy; Brian Chen, University of South Carolina, Columbia, SC; Dawn L. Hershman, Columbia University, New York, NY; and Norman Marks, Medical Product Place, Gaithersburg, MD
| | - Charles L Bennett
- John Bian, LeAnn Norris, Richard Schulz, and Charles L. Bennett, University of South Carolina College of Pharmacy; Brian Chen, University of South Carolina, Columbia, SC; Dawn L. Hershman, Columbia University, New York, NY; and Norman Marks, Medical Product Place, Gaithersburg, MD
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9
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May FP, Glenn BA, Crespi CM, Ponce N, Spiegel BMR, Bastani R. Decreasing Black-White Disparities in Colorectal Cancer Incidence and Stage at Presentation in the United States. Cancer Epidemiol Biomarkers Prev 2016; 26:762-768. [PMID: 28035021 DOI: 10.1158/1055-9965.epi-16-0834] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 12/18/2022] Open
Abstract
Background: There are long-standing black-white disparities in colorectal cancer incidence and outcomes in the United States. Incidence and stage at diagnosis reflect the impact of national efforts directed at colorectal cancer prevention and control. We aimed to evaluate trends in black-white disparities in both indicators over four decades to inform the future direction of prevention and control efforts.Methods: We used Surveillance, Epidemiology, & End Results (SEER) data to identify whites and blacks with histologically confirmed colorectal cancer from January 1, 1975 through December 31, 2012. We calculated the age-adjusted incidence and the proportion of cases presenting in late stage by race and year. We then calculated the annual percentage change (APC) and average APC for each indicator by race, examined changes in indicators over time, and calculated the incidence disparity for each year.Results: There were 440,144 colorectal cancer cases from 1975 to 2012. The overall incidence decreased by 1.35% and 0.46% per year for whites and blacks, respectively. Although the disparity in incidence declined from 2004 to 2012 (APC = -3.88%; P = 0.01), incidence remained higher in blacks in 2012. Late-stage disease declined by 0.27% and 0.45% per year in whites and blacks, respectively. The proportion of late-stage cases became statistically similar in whites and blacks in 2010 (56.60% vs. 56.96%; P = 0.17).Conclusions: Black-white disparities in colorectal cancer incidence and stage at presentation have decreased over time.Impact: Our findings reflect the positive impact of efforts to improve colorectal cancer disparities and emphasize the need for interventions to further reduce the incidence gap. Cancer Epidemiol Biomarkers Prev; 26(5); 762-8. ©2016 AACR.
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Affiliation(s)
- Folasade P May
- Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California. .,UCLA Kaiser Permanente Center for Health Equity, Los Angeles, California.,Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Beth A Glenn
- UCLA Kaiser Permanente Center for Health Equity, Los Angeles, California.,Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California.,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California.,Department of Biostatistics at UCLA Fielding School of Public Health, Los Angeles, California
| | - Ninez Ponce
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California
| | - Brennan M R Spiegel
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California.,Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, California
| | - Roshan Bastani
- UCLA Kaiser Permanente Center for Health Equity, Los Angeles, California.,Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California.,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California
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10
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Bian J. Overuse of colorectal cancer screening services in the United States and its implications. CHINESE JOURNAL OF CANCER 2016; 35:88. [PMID: 27634405 PMCID: PMC5025621 DOI: 10.1186/s40880-016-0148-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 06/11/2016] [Indexed: 11/10/2022]
Abstract
As a standard way for prevention and early detection of colorectal cancer (CRC), colonoscopy has been used for CRC screening in the United States for more than one decade. An article entitled “Assessing Colorectal Cancer Screening Adherence of Medicare Fee-For-Service Beneficiaries Age 76 to 95 Years” recently published at the Journal of Oncology Practice reports the trends in overuse of CRC screening services among average-risk elderly populations at the age of 76–95 years. Several reasons for overusing colonoscopy have been postulated, and some strategies for reducing overuse of CRC screening services have also been proposed.
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Affiliation(s)
- John Bian
- Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, Columbia, SC, 29208, USA.
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