The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #54509

Frederick B Dong, AM, MBA, Diane Manninen, PhD, and Linda D Winges, MA. Centers for Public Health Research and Evaluation, Battelle Memorial Institute, 4500 Sand Point Way NE, P. O. Box 5395, Seattle, WA 98105-0395, (206) 528-3120, dong@battelle.org

Background Colorectal cancer is the second leading cause of cancer related deaths in the U.S., despite evidence demonstrating the effectiveness of colorectal cancer screening. There is substantial variation in the rate of colorectal cancer screening across geographic areas. Previous studies have shown that the likelihood of screening varies by a number of individual characteristics. Differences in the distribution of individual characteristics across geographic areas may explain some of the difference in the rate of colorectal cancer screening.. Methods We estimated the rate of colorectal cancer screening for people ages 50 and older by states and the District of Columbia using the 1999 and 2001 BRFSS and computed the variation across geographic areas. We estimated the number of gastroenterologists by state from the Area Resource File and divided that by the population age 50 and older to estimate physician availability. A logit model was estimated for the likelihood of colorectal cancer screening across individuals controlling for both socio-demographic characteristics and physician availability. The parameters estimated by the logit model were used to control for differences in the characteristics across areas. Results The estimated variance across states and the District of Columbia in 1999 was 0.241%. After adjusting for socio-demographic characteristics and physician availability, the variance was 0.156%. Similarly, for 2001, the unadjusted and adjusted variance estimates were 0.374% and 0.257%. Conclusions About one-third of the variation in the rate of colorectal cancer screening across states and the District of Columbia may be attributable to differences in the number of gastroenterologist per population age 50 and older and demographic differences.

Learning Objectives:

• Evaluate the extent that the variation in screening rates may be attributable to demographic differences and differences in physician availability

Keywords: Cancer Screening, Access to Care

Presenting author's disclosure statement: