Carrie Klabunde, PhD, Applied Research Program, National Cancer Institute, EPN 4005; 6130 Executive Boulevard, Bethesda, MD 20892, 301/402-3362, klabundc@mail.nih.gov, Anna P. Schenck, MSPH, PhD, Medical Review of North Carolina, Inc, P.O. Box 37309, Raleigh, NC 27627, and William Davis, PhD, Surveillance Research Program, National Cancer Institute, 6116 Executive Boulevard, Room 5047, Bethesda, MD 20893.

Colorectal cancer screening with fecal occult blood testing (FOBT), sigmoidoscopy, colonoscopy, and double-contrast barium enema has been a covered benefit for Medicare consumers aged 50+ since 1998. Yet national data show underutilization of colorectal cancer screening by this population. To better understand reasons for less-than-optimal screening rates among Medicare beneficiaries, we surveyed 2,000 randomly-selected Medicare consumers in North and South Carolina by telephone in Fall 2001 (response rate = 68%). Of the 1,901 respondents who had no personal history of colorectal cancer, one-half had not been screened according to guidelines, and almost one-third said they had not received a recommendation from a physician to undergo screening. Among those not screened, being white (OR=2.8), younger than age 65 (OR=1.8), and at increased risk for colorectal cancer (OR=2.4), and having more than a high school education (OR=1.6), a usual source of care (OR=5.3), and a recent doctor visit (OR=1.8) were significant predictors of receiving a screening recommendation. Physician failure to order colorectal cancer tests and respondents’ lack of awareness of the need for testing were the most commonly-cited reasons for not being screened; reasons were consistent across test types (i.e., FOBT, sigmoidoscopy, and colonoscopy). These findings are noteworthy because most of the unscreened reported having a usual source of care (89%) and visiting a doctor in the past year (81%). The study highlights the need for interventions to educate Medicare consumers about the importance and Medicare coverage of colorectal cancer screening, and to prompt physicians to offer screening to their Medicare patients.

Learning Objectives:

• Identify 5 barriers to colorectal cancer screening among Medicare consumers who are not up-to-date with recommended screening
• Discuss the key role of providers in motivating Medicare consumers to obtain colorectal cancer screening
• Describe the need for interventions to educate Medicare consumers about the importance and Medicare coverage of colorectal cancer screening, and to prompt physicians to offer screening to their Medicare patients

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.