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. 2018 Sep 5;9(4):31-38.
doi: 10.4292/wjgpt.v9.i4.31.

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

Abhilash Perisetti  1 , Hafiz Khan  2 , Nayana E George  3 , Rachana Yendala  4 , Aamrin Rafiq  5 , Summre Blakely  6 , Drew Rasmussen  2 , Nathan Villalpando  2 , Hemant Goyal  7
Affiliations

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

Abhilash Perisetti et al. World J Gastrointest Pharmacol Ther. .

Abstract

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 (aORs), 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, aORs for not seeing the doctor in the past year because of cost were: stool occult blood test within last year aOR = 0.88; 95%CI: 0.76-1.02, sigmoidoscopy within last year aOR = 0.72; 95%CI: 0.48-1.07, colonoscopy within the last year aOR = 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.

Keywords: Access to care; Behavioral Risk Factor Surveillance System; Colorectal cancer; Fecal occult blood; Healthcare delivery; Screening; Sigmoidoscopy.

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Conflict of interest statement

Conflict-of-interest statement: All authors confirm that there are no financially relevant conflicts of interests.

Figures

Figure 1
Figure 1
Study design. CRC: Colorectal cancer; BRFSS: Behavioral Risk Factor Surveillance System; FOBT: Fecal Occult Blood testing.
Figure 2
Figure 2
Odds ratios for fecal occult testing, sigmoidoscopy and colonoscopy. FOTL: Fecal occult testing (same as FOBT: Fecal occult blood testing).
See this image and copyright information in PMC

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