Geographic and population-level disparities in colorectal cancer testing: A multilevel analysis of Medicaid and commercial claims data

Preventive Medicine
Melinda M DavisStephanie B Wheeler

Abstract

Morbidity and mortality from colorectal cancer (CRC) can be attenuated through guideline concordant screening and intervention. This study used Medicaid and commercial claims data to examine individual and geographic factors associated with CRC testing rates in one state (Oregon). A total of 64,711 beneficiaries (4516 Medicaid; 60,195 Commercial) became newly age-eligible for CRC screening and met inclusion criteria (e.g., continuously enrolled, no prior history) during the study period (January 2010-December 2013). We estimated multilevel models to examine predictors for CRC testing, including individual (e.g., gender, insurance, rurality, access to care, distance to endoscopy facility) and geographic factors at the county level (e.g., poverty, uninsurance). Despite insurance coverage, only two out of five (42%) beneficiaries had evidence of CRC testing during the four year study window. CRC testing varied from 22.4% to 46.8% across Oregon's 36 counties; counties with higher levels of socioeconomic deprivation had lower levels of testing. After controlling for age, beneficiaries had greater odds of receiving CRC testing if they were female (OR 1.04, 95% CI 1.01-1.08), commercially insured, or urban residents (OR 1.14, 95% CI 1...Continue Reading

References

Jul 27, 1999·Journal of General Internal Medicine·M PignoneR Harris
Aug 24, 1999·Cancer Causes & Control : CCC·C A TomeoD J Hunter
Dec 3, 2002·Archives of Internal Medicine·Cynthia W KoLaura-Mae Baldwin
Mar 8, 2005·Preventive Medicine·Sherri Sheinfeld Gorin, Julia E Heck
Oct 12, 2005·Archives of Internal Medicine·Ann S O'MalleyJeanne Mandelblatt
Feb 16, 2006·Journal of Epidemiology and Community Health·Mario SchootmanMark S Walker
Mar 31, 2006·American Journal of Public Health·Randi L WolfSteven Shea
Sep 25, 2007·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Deborah A MarshallNathalie A Kulin
Oct 13, 2007·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Anna P SchenckDavid F Ransohoff
Apr 3, 2008·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Anna P SchenckDavid F Ransohoff
Jan 31, 2009·International Journal of Epidemiology·S V SubramanianNancy Krieger
May 9, 2009·American Journal of Preventive Medicine·Anna P SchenckMartin L Brown
Jul 22, 2009·Journal of Immigrant and Minority Health·Lina JandorfKatherine Duhamel
Oct 10, 2009·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Sandi L PruittBenjamin C Amick
Apr 23, 2010·American Journal of Preventive Medicine·Resa M JonesSteven H Woolf
Jul 9, 2011·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Deepa NaishadhamAhmedin Jemal
Dec 14, 2011·Health Services Research·Jaime Benarroch-GampelTaylor S Riall
May 10, 2012·Journal of the American Board of Family Medicine : JABFM·Thad WilkinsRobert R Schade
Jun 19, 2012·American Journal of Preventive Medicine·Susan A SabatinoUNKNOWN Community Preventive Services Task Force
Jul 21, 2012·The American Journal of the Medical Sciences·Samir GuptaCelette Sugg Skinner
Dec 12, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Allison E AndersonAnita Y Kinney
Apr 9, 2013·Cancer Causes & Control : CCC·Constance M JohnsonDonald A Berry
Oct 30, 2013·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Mary E CharltonPeter J Kaboli
Apr 1, 2014·Journal of the National Cancer Institute·Samir GuptaMaria Elena Martinez
Apr 24, 2014·European Journal of Cancer Care·D Dodou, J C F de Winter
Jan 1, 2012·Annals of the Association of American Geographers·Lee R MobleyLuc Anselin
Jul 9, 2014·Journal of Cancer Education : the Official Journal of the American Association for Cancer Education·Katherine Josa BriantBeti Thompson
Jan 21, 2015·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Chinedum O OjinnakaJane N Bolin
Apr 26, 2015·Journal of Community Health·Alejandro G HughesAmr S Soliman
Jun 10, 2015·Health Economics Review·Lee R MobleyH E Frech
Jul 15, 2015·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Rebecca L SiegelAhmedin Jemal
Nov 27, 2015·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Mary E CharltonBarcey T Levy

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Citations

Jul 23, 2019·Health Education Research·Judy Y OuDeanna Kepka
Sep 15, 2017·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Stephanie B Wheeler, Melinda M Davis
Mar 29, 2020·Journal of Genetic Counseling·Teala W AlvordJackilen Shannon
Dec 23, 2019·Journal of Behavioral Medicine·Cindy B VeldhuisKristine Molina
May 11, 2019·BMC Health Services Research·Meghan C O'LearyMelinda M Davis
Jan 23, 2019·BMC Health Services Research·Melinda M DavisStephanie B Wheeler
Jun 15, 2019·Journal of the National Cancer Institute·Diana R WithrowMeredith S Shiels
Nov 3, 2020·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Jennifer L MossKathleen A Cronin
Dec 18, 2020·Frontiers in Public Health·Mesnad AlyabsiShinobu Watanabe-Galloway
Jun 16, 2019·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Jennifer L MossMandi Yu
Jun 4, 2019·The Journal of Surgical Research·Osayande OsagiedeDorin T Colibaseanu
Apr 24, 2021·Cancer Prevention Research·Xuan ZhuLila J Finney Rutten
Aug 18, 2021·Preventive Medicine Reports·Xuan ZhuLila J Finney Rutten
Nov 24, 2020·American Journal of Preventive Medicine·Cynthia M MojicaMelinda M Davis
Nov 17, 2021·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Shinobu Watanabe-GallowayKrishtee Napit
May 30, 2020·Journal of Patient Safety·Anjana E SharmaUrmimala Sarkar

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