Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States

Objectives We study a cohort of Medicare-insured men and women aged 65+ in the year 2000, who lived in 11 states covered by Surveillance, Epidemiology, and End Results (SEER) cancer registries, to better understand various predictors of endoscopic colorectal cancer (CRC) screening. Methods We use mu...

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Main Authors:	Mobley, L., Kuo, T. M., Urato, M., Boos, J., Lozano-Gracia, N., Anselin, L.
Format:	Journal Article
Language:	EN
Published:	2012
Online Access:	http://hdl.handle.net/10986/5294

id	okr-10986-5294
recordtype	oai_dc
spelling	okr-10986-52942021-04-23T14:02:21Z Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States Mobley, L. Kuo, T. M. Urato, M. Boos, J. Lozano-Gracia, N. Anselin, L. Objectives We study a cohort of Medicare-insured men and women aged 65+ in the year 2000, who lived in 11 states covered by Surveillance, Epidemiology, and End Results (SEER) cancer registries, to better understand various predictors of endoscopic colorectal cancer (CRC) screening. Methods We use multilevel probit regression on two cross-sectional periods (2000-2002, 2003-2005) and include people diagnosed with breast cancer, CRC, or inflammatory bowel disease (IBD) and a reference sample without cancer. Results Men are not universally more likely to be screened than women, and African Americans, Native Americans, and Hispanics are not universally less likely to be screened than whites. Disparities decrease over time, suggesting that whites were first to take advantage of an expansion in Medicare benefits to cover endoscopic screening for CRC. Higher-risk persons had much higher utilization, while older persons and beneficiaries receiving financial assistance for Part B coverage had lower utilization and the gap widened over time. Conclusions Screening for CRC in our Medicare-insured sample was less than optimal, and reasons varied considerably across states. Negative managed care spillovers were observed, demonstrating that policy interventions to improve screening rates should reflect local market conditions as well as population diversity. 2012-03-30T07:32:10Z 2012-03-30T07:32:10Z 2010 Journal Article Cancer Causes & Control 0957-5243 http://hdl.handle.net/10986/5294 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article United States
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	EN
geographic_facet	United States
relation	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
description	Objectives We study a cohort of Medicare-insured men and women aged 65+ in the year 2000, who lived in 11 states covered by Surveillance, Epidemiology, and End Results (SEER) cancer registries, to better understand various predictors of endoscopic colorectal cancer (CRC) screening. Methods We use multilevel probit regression on two cross-sectional periods (2000-2002, 2003-2005) and include people diagnosed with breast cancer, CRC, or inflammatory bowel disease (IBD) and a reference sample without cancer. Results Men are not universally more likely to be screened than women, and African Americans, Native Americans, and Hispanics are not universally less likely to be screened than whites. Disparities decrease over time, suggesting that whites were first to take advantage of an expansion in Medicare benefits to cover endoscopic screening for CRC. Higher-risk persons had much higher utilization, while older persons and beneficiaries receiving financial assistance for Part B coverage had lower utilization and the gap widened over time. Conclusions Screening for CRC in our Medicare-insured sample was less than optimal, and reasons varied considerably across states. Negative managed care spillovers were observed, demonstrating that policy interventions to improve screening rates should reflect local market conditions as well as population diversity.
format	Journal Article
author	Mobley, L. Kuo, T. M. Urato, M. Boos, J. Lozano-Gracia, N. Anselin, L.
spellingShingle	Mobley, L. Kuo, T. M. Urato, M. Boos, J. Lozano-Gracia, N. Anselin, L. Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States
author_facet	Mobley, L. Kuo, T. M. Urato, M. Boos, J. Lozano-Gracia, N. Anselin, L.
author_sort	Mobley, L.
title	Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States
title_short	Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States
title_full	Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States
title_fullStr	Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States
title_full_unstemmed	Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States
title_sort	predictors of endoscopic colorectal cancer screening over time in 11 states
publishDate	2012
url	http://hdl.handle.net/10986/5294
_version_	1764394561147240448

Predictors of Endoscopic Colorectal Cancer Screening Over Time in 11 States

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