Colorectal cancer is the second leading cause of cancer death in the United States. Regular screening can save lives by detecting cancer at an earlier stage. In 1998, Medicare added coverage of four colorectal cancer screenings: fecal occult blood tests (FOBT); sigmoidoscopy; colonoscopy and barium enema. To determine screening use, we analyzed Medicare claims for diagnostic colorectal cancer tests for 1996-1998 and for screening tests for 1998 among North Carolina Medicare beneficiaries. Paid and denied claims for outpatient and inpatient services were analyzed. North Carolina Medicare beneficiary files were used to determine eligibility for testing. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between selected characteristics and the likelihood of receiving a screening test. In 1998, use rates for any diagnostic test were 15%; for any screening test, 6%. Combined rate for any colorectal cancer test (screening or diagnostic) among Medicare enrollees age 50 and older in 1998 was 19%. Odds ratios from logistic models showed African Americans were less likely to be screened (OR=0.50, 95% CI: 0.49-0.52) as were those of low income (OR=0.33, 95% CI: 0.32-0.34) and those residing in rural areas (OR=0.90, 95%CI: 0.88-0.92). These data demonstrate considerable room for improvement in the use of screening tests in the Medicare population. The results support the need for educational outreach among both Medicare beneficiaries and their providers about the importance of and coverage for colorectal cancer screening tests.
Learning Objectives: 1. Participants will understand the Medicare colorectal cancer screening benefits. 2. Participants will learn about coding and usage differences between diagnostic and screening tests. 3. Participants will be able to indentify groups at risk of not getting appropriate tests.
Keywords: Medicare, Cancer Screening
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.