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Addressing disparities in colorectal cancer screening

Mona Sarfaty, MD, Health Policy, Thomas Jefferson University, 1015 Walnut Avenue, Philadelphia, PA 19107, 610-520-0380, monasarfaty@yahoo.com and Shibao Feng, PhD, Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center, Suite 180, Building D, 4000 Reservoir Rd NW, Washington, DC 20057.

One of the goals of Healthy People 2010 (HP2010) is to eliminate disparities like those that exist in colorectal cancer (CRC) incidence and mortality. While focus on the entire population over age 50 is needed, special attention must go to groups with disparities. Information is needed about what approaches elicit participation of under-served populations in screening. The advice of a physician has been demonstrated to be effective in getting individuals to complete cancer screening; there have been fewer reports evaluating media campaigns. We compared media outreach to physician referral, and to community outreach for impact on completing CRC screening. We studied a diverse, low-income, uninsured population in a county that provided free screening with colonoscopy to people age 50 and over who met eligibility requirements. All were processed in a similar fashion with cultural and linguistic competence by an RN case manager. Results showed that the individuals who were directly referred by a physician and those who telephoned in response to media outreach were comparable in sociodemographic factors and prior screening rates. They differed by whether they had a usual source of care (83% vs. 56%), and by percent symptomatic (31% vs. 38%). Over 60% of each group completed screening. Entry route was a significant factor associated with completion of screening, but race and ethnicity were not. Where access is assured and other barriers are minimized, media outreach may be a low cost way to improve colorectal cancer screening rates for under-served low income uninsured populations.

Learning Objectives: The learner will be able to

Keywords: Cancer Screening, Media Campaigns

Presenting author's disclosure statement:

Any relevant financial relationships? No

Cancer Screening: A Health Promotion Challenge

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA