American Association for Cancer Research – InsuranceNewsNet

July 13, 2022 (NewsRx) — By a News Reporter – Staff News Editor at Daily Insurance News — Bottom Line: In 2018, Americans ages 50-54 were 30.4% less likely to meet recommended colorectal cancer screening guidelines than Americans ages 70-75 and faced screening disparities higher by race, ethnicity, household income, level of education and insurance coverage.

Journal in which the study was published: Cancer Epidemiology, Biomarkers & Prevention, a journal of American Association for Cancer Research

Author: Caitlin MurphyPhD, MPH, Associate Professor at the UTHealth School of Public Health

Context: In May 2021the US Task Force on Preventive Services (USPSTF) updated their guidelines to recommend colorectal cancer screening for all individuals starting at age 45, five years earlier than the previous recommendation. The change was based on the increasing incidence of colorectal cancer in adults under 50; According to federal statistics, people aged 45 to 54 accounted for 15.1% of colorectal cancer cases and 9.2% of colorectal cancer deaths from 2015 to 2019.

Because younger people face unique barriers to screening, Murphy and colleagues sought to predict screening disparities that may arise in the new age group by examining screening patterns in the previously the youngest, those aged 50 to 54. These barriers include work and family demands, insufficient insurance coverage, and fewer health care visits in general, which can disproportionately affect racial and ethnic minorities and socioeconomically disadvantaged people, a said Murphy.

“The screening disparities that have been observed in older adults may extend to adults ages 45 to 49 as new USPSTF recommendations are implemented,” she continued.

How the study was conducted: The researchers used data from National Health Interview Survey (NHIS), a comprehensive annual health survey administered by the US Centers for Disease Control and Prevention (CDC) to a diverse group of U.S. participants. Participation in colorectal cancer screening was assessed for eight discontinuous years between 2000 and 2018, and data from these eight years were included in the study.

The study population consisted of 80,220 participants between the ages of 50 and 75 with complete colorectal cancer screening information and no personal history of colorectal cancer. Screening was self-reported and defined as a stool-based test within the past year, a fecal immunochemical DNA test within the past three years, a colonogram or sigmoidoscopy within the past five years, or a colonoscopy within of the last 10 years.

Results: Participation in colorectal cancer screening increased over time, but the increase was smallest among people aged 50 to 54, rising from 28.2% in 2000 to 47.6% in 2018. In contrast, screening among people aged 70 to 75 increased from 46.4% in 2000 to 78.0% in 2018.

In 2018, larger disparities in testing were observed between people of different racial and ethnic groups, education levels, household income and health insurance coverage among people aged 50 to 54 compared to older people from 70 to 75 years old. Notable differences include:

Author Comments: These data, Murphy said, demonstrate that many screening disparities are concentrated in younger age groups, and she suggested that similar issues could be seen in people aged 45-49. years under the new directives. Although she stressed that it may take several years for data from the new guidelines to become available, Murphy urged further research on barriers to testing among young adults and how to implement interventions. evidence-based to increase testing of these individuals.

“Across all age groups, participation in colorectal cancer screening remains below national targets, and the benefits of screening are not being realized equally across all populations,” Murphy said. “Additional precautions should be taken to ensure that expanding screening to younger ages does not negatively impact efforts to eliminate disparities in colorectal screening and outcomes, or undermine efforts to increase screening initiation among older people who remain unscreened.

Study limitations: Limitations of this study include self-reporting of screening behaviors by survey, as well as a lack of data regarding those at high risk for colorectal cancer.

Funding and Disclosures: This study was funded by the National Institutes of Health and the Texas Cancer Prevention and Research Institute. Murphy is a consultant for Freenome.

Learn about the latest research on cancer-related health disparities, key facts and figures related to cancer disparities, and AACR’s advocacy for health equity in the Progress Report AACR Cancer Disparities 2022.

(Our reports provide factual information on research and discoveries from around the world.)

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