Lack of access to health care may be to blame
ATLANTA — A new study suggests that a drop in colorectal cancer incidence seen nationwide has not occurred among people living in poorer communities, and suggests that barriers to health care may be to blame. The study appears online in the journal Cancer Causes and Control.
Colorectal cancer (CRC) incidence rates have decreased rapidly in the United States since 1998, in large part from the use of endoscopic screening, which can detect and remove polyps before they turn into cancer. However, studies have not fully explored whether all populations, including people of different ages, race/ethnicity, and with differing levels of access to medical care have seen such a drop.
The authors say the study suggests that the decrease in incidence rates among whites 65 and older across all categories of counties may in part reflect an increase in endoscopic screening rates after Medicare expanded reimbursement of selected screening tools in 1998 and 2001. In contrast, the lack of decrease in CRC incidence rates among some population subgroups, including those 50 to 64 year old Hispanics and African Americans in general and whites residing in the most disadvantaged areas, may reflect lack of access to primary care as well as endoscopic screening services.
The authors conclude that that individuals residing in poorer communities with lower access to medical care have not experienced the reduction in CRC incidence rates that have benefited more affluent communities, and that this is likely explained in part by lower utilization of colorectal endoscopic screening even in older populations with coverage through Medicare. They say further research is needed on factors that explain the disparities and potential interventions to address them. ###
Article: "Trends in colorectal cancer incidence rates by age, race/ethnicity, and indices of access to medical care, 1995–2004 (United States)" Yongping Hao, Ahmedin Jemal, Xingyou Zhang, Elizabeth M. Ward. Cancer Causes Control DOI 10.1007/s10552-009-9379-y, Published online June 19, 2009.
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