Colorectal cancer screening use among insured adults: Is out-of-pocket cost a barrier to routine screening?  

作　　者：Abhilash Perisetti Hafiz Khan Nayana E George Rachana Yendala Aamrin Rafiq Summre Blakely Drew Rasmussen Nathan Villalpando Hemant Goyal 

机构地区：[1]Department of Gastroenterology, University of Arkansas for Medical Sciences [2]Department of Public Health, Texas Tech University Health Sciences [3]Department of Internal Medicine, University of Arkansas Medical Sciences [4]Department of Hematology and Oncology, Texas Tech University Health Sciences [5]Department of Biological Sciences, Texas Tech University [6]School of Medicine, Texas Tech University Health Sciences Center [7]Department of Internal Medicine, Mercer University School of Medicine

出　　处：《World Journal of Gastrointestinal Pharmacology and Therapeutics》2018年第4期31-38,共8页世界胃肠药理与治疗学杂志（英文版）（电子版）

摘　　要：AIM To describe the characteristics of adults who needed to see a doctor in the past year but could not due to the extra cost and assess the impact of limited financial resources on the receipt of routine fecal occult blood test, sigmoidoscopy, or colonoscopy for colon cancer screening among insured patients. METHODS Data obtained from the 2012 Behavioral Risk Factor Surveillance System included 215436 insured adults age 50-75 years. We computed frequencies, adjusted odds ratios(a ORs), and 95%CIs using SAS v9.3 software. RESULTS Nine percent of the study population needed to see a doctor in the past year but could not because of cost. The numbers were significantly higher among those aged 50-64(P < 0.0001), Non-Hispanic Whites(P < 0.0001), and those with a primary care physician(P < 0.0001) among other factors. Adjusting for possible confounders, a ORs for not seeing the doctor in the past year because of cost were: stool occult blood test within last year a OR = 0.88; 95%CI: 0.76-1.02, sigmoidoscopy within last year a OR = 0.72; 95%CI: 0.48-1.07, colonoscopy within the last year a OR = 0.91; 95%CI: 0.81-1.02. CONCLUSION We found that the limited financial resources within the past 12 mo were significantly associated with colorectal cancer(CRC) non-screening. Patients with risk factors identified in this study should adhere to CRC guidelines and should receive financial help if needed.AIM To describe the characteristics of adults who needed to see a doctor in the past year but could not due to the extra cost and assess the impact of limited financial resources on the receipt of routine fecal occult blood test, sigmoidoscopy, or colonoscopy for colon cancer screening among insured patients. METHODS Data obtained from the 2012 Behavioral Risk Factor Surveillance System included 215436 insured adults age 50-75 years. We computed frequencies, adjusted odds ratios(a ORs), and 95%CIs using SAS v9.3 software. RESULTS Nine percent of the study population needed to see a doctor in the past year but could not because of cost. The numbers were significantly higher among those aged 50-64(P < 0.0001), Non-Hispanic Whites(P < 0.0001), and those with a primary care physician(P < 0.0001) among other factors. Adjusting for possible confounders, a ORs for not seeing the doctor in the past year because of cost were: stool occult blood test within last year a OR = 0.88; 95%CI: 0.76-1.02, sigmoidoscopy within last year a OR = 0.72; 95%CI: 0.48-1.07, colonoscopy within the last year a OR = 0.91; 95%CI: 0.81-1.02. CONCLUSION We found that the limited financial resources within the past 12 mo were significantly associated with colorectal cancer(CRC) non-screening. Patients with risk factors identified in this study should adhere to CRC guidelines and should receive financial help if needed.

关 键 词：FECAL OCCULT blood Healthcare delivery SIGMOIDOSCOPY Colorectal cancer Screening Access to care Behavioral Risk Factor Surveillance System 

分 类 号：R[医药卫生]