<p class="first" id="d1548219e184">Regular colorectal cancer (CRC) screening is recommended
for reducing CRC incidence
and mortality. This paper provides an updated analysis of CRC screening in the United
States (US) and examines CRC screening by several features of health insurance coverage.
Recommendation-consistent CRC screening was calculated for adults aged 50-75 in 2008,
2010, 2013 and 2015 using data from the National Health Interview Survey. CRC screening
prevalence in 2015 was described overall and by sociodemographic subgroups. CRC screening
by health insurance coverage was further examined using multivariable logistic regression,
stratified by age (50-64 years and 65-75 years) and adjusted for age, race/ethnicity,
sex, education, income, time in US, and comorbid conditions. Recommendation-consistent
screening increased from 51.6% in 2008 to 58.3% in 2010 (p < 0.001). Use plateaued
from 2010 to 2013 but increased to 61.3% in 2015 (p < 0.001). In 2015, adults aged
50-64 years with traditional employer-sponsored private insurance were more likely
to be screened (62.2%) than those with traditional private direct purchase plans (50.9%)
and the uninsured (24.8%) (p < 0.01, respectively). After multivariable adjustment,
differences between traditional employer-sponsored private insurance and the uninsured
remained statistically significant. Adults aged 65-75 with Medicare and private insurance
were more likely to be screened (76.3%) than those with Medicare, no supplemental
insurance (68.8%) or Medicare and Medicaid (65.2%) (p < 0.001). After multivariable
adjustment, the differences between Medicare and private insurance and Medicare no
supplemental insurance remained statistically significant. CRC screening rates have
increased over time, but certain segments of the population, especially the uninsured,
continue to screen below recommended levels.
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