Embargoed for Release Until: Sunday, November 2, 1997, 6:00 p.m. Contact: Marie Kendra Tehonica (202) 973-1361
Overcoming Barriers to Colorectal Cancer Screening: Two New Studies Find Health Insurance Coverage A Major Factor in Screening Compliance
November 2, 1997, Chicago, IL -- Despite the widespread consensus on the importance of regular colorectal cancer screening, and new guidelines from the American Cancer Society, compliance with screening suffers because of a range of factors, including type of health insurance coverage, encouragement of screening by managed care organizations, and patient perceptions of the screening experience, according to studies presented at the 62nd Annual Scientific Meeting of the American College of Gastroenterology.
V. Alin Botoman, MD, FACG of the Cleveland Clinic Florida studied patients entering a new Medicare HMO in Florida and found that 94% were encouraged by the new health plan to seek colorectal cancer screening by flexible sigmoidoscopy, but only 46% had been aware or encouraged by their previous health care plan to participate in this type of screening. These patients were more likely to have more and larger polyps, a precursor to colorectal cancer. Among those who had been screened by a previous health care plan, there were significantly fewer polyps detected. Almost three-quarters of the polyps identified in the study were found in patients entering the program from a managed care plan.
Factors influencing continued participation in a colorectal cancer screening regimen was the subject research by Ann M. DiPalma and Jack A. DiPalma, MD, FACG at the University of South Alabama College of Medicine. The DiPalmas surveyed 95 participants screened in 1991 as part of a gastroenterologist-directed, aggressively managed colon cancer screening registry which tracked patients with regular notices and reminders to their primary care providers for annual stool blood tests and flexible sigmoidoscopy screening every 3 to 5 years. Of the 65 eligible respondents, 49% had dropped out of screening, citing as their reasons: they were unaware that they needed to return for screening (14); they were too busy (6); they found the experience unpleasant (3); or their insurance did not cover screening (9).
Most colon cancers develop from benign polyps. Early removal of polyps during screening can eliminate most colon cancers. For normal risk individuals, screening tests should begin at age 50 and consist of annual stool test for blood, and a flexible sigmoidoscopic exam every 3 to 5 years. Screening colonoscopy every 1 to 2 years is recommended for individuals at higher than normal risk for colon cancer, including those with a past history of colorectal cancer, family history of colorectal cancer or polyps, or inflammatory bowel disease. For both average and high risk individuals, all potential pre-cancerous polyps must be removed.
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The ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners.
Consumers can get more information on GI diseases through the following ACG-sponsored programs:
* 1-800-978-7666 (free brochures on common GI disorders, including ulcers, colon cancer, gallstones and liver disease)
* 1-800-HRT-BURN (free brochure and video on heartburn and GERD)
* www.acg.gi.org (ACG's web site)
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