Colorectal Cancer Screening in the Era of the Affordable Care Act

Journal of General Internal Medicine
Ilana RichmanDouglas K Owens

Abstract

The Affordable Care Act (ACA) eliminated cost-sharing for evidence-based preventive services in an effort to encourage use. To evaluate use of colorectal cancer (CRC) screening in a national population-based sample before and after implementation of the ACA. Repeated cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) between 2009 and 2012 comparing CRC screening rates before and after implementation of the ACA. Adults 50-64 with private health insurance and adults 65-75 with Medicare. Self-reported receipt of screening colonoscopy, sigmoidoscopy, or fecal occult blood test (FOBT) within the past year among those eligible for screening. Our study included 8617 adults aged 50-64 and 3761 adults aged 65-75. MEPS response rates ranged from 58 to 63%. Among adults aged 50-64, 18.9-20.9% received a colonoscopy in the survey year, 0.59-2.1% received a sigmoidoscopy, and 7.9-10.4% received an FOBT. For adults aged 65-75, 23.6-27.7% received a colonoscopy, 1.3-3.2% a sigmoidoscopy, and 13.5-16.4% an FOBT. In adjusted analyses, among participants aged 50-64, there was no increase in yearly rates of colonoscopy (-0.28 percentage points, 95% CI -2.3 to 1.7, p = 0.78), sigmoidoscopy (-1.1%, 95% CI -1.7 to -0.46, p = <0....Continue Reading

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Citations

Dec 5, 2017·Health Affairs·Elisabeth F P PeterseIris Lansdorp-Vogelaar
Jun 19, 2019·BMC Health Services Research·Wendy Yi XuJeah Kyoungrae Jung
May 26, 2017·The Cancer Journal·Christine LeopoldLarissa Nekhlyudov
May 26, 2017·The Cancer Journal·Lindsay M Sabik, Georges Adunlin
Dec 18, 2020·Frontiers in Public Health·Mesnad AlyabsiShinobu Watanabe-Galloway
Apr 7, 2021·Contemporary Clinical Trials·Sally W VernonRonald E Myers
Aug 4, 2021·Health Economics·Marianne P BitlerDanea Horn
Feb 6, 2020·American Journal of Preventive Medicine·Michelle R XuDonna Spiegelman

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