The 130th Annual Meeting of APHA

Abstract #44451

Anna Pittman Schenck, PhD, Health Assessment Division, Medical Review of North Carolina, 5625 Dillard Drive, Cary, NC 27511, 919 851-2955, ncpro.aschenck@sdps.org, Carrie Klabunde, PhD, Applied Research Program, National Cancer Institute, EPN 4005; 6130 Executive Boulevard, Bethesda, MD 20892, Renee Taylor, MPH, Health Care Assessment, Medical Review of North Carolina, Inc., PO Box 37309, Raleigh, NC 27627, and Nelson Gunter, MD, Carolina Medical Review, 250 Berryhill Rd., Suite 101, Columbia, SC 29210.

Regular screenings detect colorectal cancer at an earlier, more treatable stage thereby reducing the burden of colorectal cancer, the second leading cause of cancer death in the U.S. Because colorectal cancer risk increases with age, it is especially important that Medicare enrollees be screened. Although Medicare covers colorectal cancer screening, testing among Medicare consumers is underutilized. To plan for an intervention to increase screening among Medicare consumers in North and South Carolina, we conducted a telephone survey to assess knowledge, attitudes and behaviors concerning colorectal cancer screening, and identify potential barriers to screening. Intervention and comparison areas were selected for each state. Medicare enrollment files were used to select a random sample of beneficiaries ages 50 – 80 in each targeted area. Odds ratios (OR’s) and 95% confidence intervals (CIs) were calculated to identify predictors of screening. A total of 2004 interviews were completed (cooperation rate=68%). Only 19% of respondents expressed accurate understanding of colorectal cancer risk factors. Less than half (46%) were aware of the Medicare screening benefit. One-half (53%) reported having a colorectal cancer test within the recommended time interval. Physician recommendation was strongly associated with testing according to guidelines (OR=3.5, 95% CI: 3.3 – 3.9). Over one-quarter (28%) had not received a physician recommendation. Results illustrate the utility of survey data for planning and evaluating an organized program to increase colorectal cancer screening in a targeted population. They also highlight the need for tools to assist physicians in identifying and educating patients about appropriate colorectal cancer screening.

Learning Objectives:

• Recognize the importance of survey data as a planning and evaluation tool for screening intervention efforts.
• Identify barriers to colorectal cancer screening for Medicare consumers.
• List materials and activities that may be effective in increasing colorectal cancer screening rates among Medicare consumers.

Keywords: Cancer Screening, Medicare

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 2025.0 kb)