RESEARCH ARTICLEInitiation of Colorectal Cancer Screening Among Medicaid Enrollees
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INTRODUCTION
Colorectal cancer (CRC) is the second most common cause of cancer death in the U.S.1,2 The U.S. Preventive Services Task Force recommends that screening for CRC begin at age 50 years for average-risk adults and endorses high-sensitivity fecal occult blood testing (FOBT) every year, sigmoidoscopy every 5 years, or colonoscopy every 10 years.3 Despite the availability of effective screening tools, screening for CRC remains widely underutilized.4 National data suggest that only 60% of publicly
METHODS
Timely and reliable Medicaid enrollment and claims data (January 2013 to June 2015) were obtained from the Oregon Health Authority20 under a data use agreement with the Oregon Health & Science University. The data included monthly enrollment numbers, demographic information, and claims data for enrollees with healthcare encounters. The IRBs at Oregon State University and the Oregon Health & Science University approved the study.
RESULTS
Table 1 provides descriptive statistics for the 9,032 study-eligible Medicaid enrollees who turned age 50 years in 2013 (51%) and 2014 (49%). Sixty-nine percent of enrollees self-identified as non-Hispanic white; 13% self-identified as Hispanic, and 18% were an other race/ethnicity. More than half (57%) of the enrollees lived in an urban area, and 53% had more than one comorbidity. Enrollees had a mean of 5 primary care visits, and 75% had at least 1 primary care visit in the year after turning
DISCUSSION
Among newly age-eligible Medicaid enrollees in Oregon, 17% initiated CRC screening, that is, received any CRC screening in the first year after turning 50 years; of these, 64% received a colonoscopy, which is consistent with the previous research of publicly insured adults.15,32,33 A CRC screening initiation was associated with race/ethnicity, residence, comorbidities, primary care visits, number of providers, and percentage of Medicaid panel aged eligible for CRC screening. The finding that
CONCLUSIONS
Among this newly age-eligible Medicaid population, only 17% of Medicaid enrollees initiated CRC screening, that is, received any CRC screening in the year after turning 50 years. However, during the past decade, Oregon has been actively involved in efforts to increase CRC screening. Compared with 2010, Oregon has experienced a significant increase in CRC screening among newly age-eligible individuals who enrolled in Medicaid during 2013 and 2014.17 In 2012, Oregon transformed its healthcare
ACKNOWLEDGMENTS
The content is solely the responsibility of the authors and does not necessarily represent the official views of the Knight Cancer Institute or NIH. Neither of the study sponsors had any role in the study design, data collection, data analysis, interpretation of findings, writing of the manuscript, or in the decision to submit this manuscript for publication.
The study was supported by the Knight Cancer Institute-Oregon Health & Sciences University/Oregon State University Cancer Prevention and
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2023, Journal of the National Medical AssociationPredictors of Colorectal Cancer Screening Modality Among Newly Age-Eligible Medicaid Enrollees
2021, American Journal of Preventive MedicineCitation Excerpt :Screening for colorectal cancer (CRC) saves lives, yet nationally only 45% of Medicaid enrollees aged 50–64 years are up to date with CRC screening guidelines1 compared with 63.3% of U.S. adults aged 50–64 years.2 Further, prior work from this research team found that only 17% of newly age-eligible Medicaid enrollees in Oregon initiated CRC screening within 1 year of turning age 50 years.3 In general, the most widely used screening tests in the U.S. are fecal immunochemical tests (FITs) or fecal occult blood tests (FOBTs) and colonoscopy.4
Clinic Factors Associated With Mailed Fecal Immunochemical Test (FIT) Completion: The Difference-Making Role of Support Staff
2022, Annals of Family MedicineCitation Excerpt :Our approach identified modifiable factors that individual clinics or learning health care systems57,58 can address to improve FIT screening. Although systems might have standardized protocols and centralized programs to support population outreach, clinic-level activities also contribute to program effectiveness.27,59 Research has shown that CRC screening rates are higher for those who attend ≥1 clinic visit in the prior year, compared with those with no clinic visits.21,22,60
Patient preferences for the design of a pharmacy-based colorectal cancer screening program
2023, Cancer Causes and Control