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Racial Disparities Persist in Colorectal Cancer Screening

Despite increased Medicare coverage, blacks and Hispanics less likely to be screened than whites

THURSDAY, May 5 (HealthDay News) -- Racial or ethnic differences in colorectal cancer (CRC) screening persist, especially in blacks and Hispanics, despite expanded Medicare coverage for CRC screening tests, according to a study published in the May issue of Cancer Epidemiology, Biomarkers & Prevention.

Arica White, Ph.D., from the University of Texas Health Science Center in Houston, and colleagues examined the effect of Medicare's expanded CRC screening test reimbursement on racial/ethnic disparities in CRC screening in 30,893 Medicare beneficiaries, aged 70 to 89 years. Participants had no history of tumor and lived in 16 Surveillance, Epidemiology and End Results regions of the United States from 1996 to 2005. CRC screening tests were identified in a 5 percent sample of all Medicare claims. Age- and gender-adjusted percentages and odds were reported for participants receiving any guideline-specific CRC screening (annual fecal occult blood test [FOBT], sigmoidoscopy every five years, or colonoscopy every 10 years), according to race/ethnicity and Medicare coverage expansion period (prior or current FOBT coverage only, and after colonoscopy coverage).

The investigators found that, with the expansion of Medicare coverage, CRC screening increased for both white and black Medicare beneficiaries, but blacks were less likely to receive screening before FOBT coverage (odds ratio [OR], 0.74), only during FOBT coverage (OR, 0.66), and after colonoscopy coverage (OR, 0.80), compared to whites. Screening after colonoscopy coverage was less likely in Hispanics (OR, 0.73).

"Racial disparities in CRC screening persisted, despite the expansion of Medicare CRC screening test reimbursement for average-risk persons," the authors write.

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