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Colorectal Screening Called Inadequate

MANAGED CARE January 2014. © MediMedia USA
News & Commentary

Colorectal Screening Called Inadequate

A third of Americans ages 50 to 70 — about 23 million people — have never been screened for colorectal cancer, according to the Centers for Disease Control and Prevention.

This is despite the consensus that screening saves lives.

The U.S. Preventive Services Task Force recommends screening with colonoscopy every 10 years, or sigmoidoscopy every five years, or fecal occult blood test every year for patients who are not at risk.

CDC Director Tom Frieden, MD, says that the main reason people are not screened is that their doctors forget to recommend it. That’s unfortunate because, as the study says, “Primary care providers are the most common source for a CRC [colorectal cancer] screening recommendation.”

Colorectal cancer kills about 50,000 people a year, making it the leading killer of nonsmokers.

The study “Vital Signs: Colorectal Cancer Screening Test Use — United States, 2012” (http://tinyurl.com/CDC-screening-study) was in the agency’s Morbidity and Mortality Weekly Report on November 9.

Not surprisingly, people who don’t have health insurance are less likely to be screened (about 37% of non-insured are screened). Coverage does not mean compliance, though.

The study states that “among those who had never been screened, 76% actually had health insurance, so additional interventions are needed even among those with access to health care.”

The CDC would like to see an outreach effort similar to the ones for “immunization and screening for sexually transmitted diseases, [which] have been successful in substantially increasing CRC screening in several settings.” The report cites a recent study in which mailing reminders to patients who needed to be screened increased screening rates.