A population-based study of colorectal cancer test use

Results from the 2001 California Health Interview Survey

Authors

  • David A. Etzioni M.D., M.S.H.S.,

    1. Department of Surgery, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California
    2. Robert Wood Johnson Clinical Scholars Program, University of California at Los Angeles, Los Angeles, California
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  • Ninez A. Ponce Ph.D., M.P.P.,

    Corresponding author
    1. Department of Health Services, University of California at Los Angeles Center for Health Policy Research and the University of California at Los Angeles School of Public Health, Los Angeles, California
    • University of California at Los Angeles Center for Health Policy Research, 10911 Weyburn Avenue, Suite 300, Los Angeles, CA 90024
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    • Fax: (310) 794-2686

  • Susan H. Babey Ph.D.,

    1. Department of Health Services, University of California at Los Angeles Center for Health Policy Research and the University of California at Los Angeles School of Public Health, Los Angeles, California
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  • Benjamin A. Spencer M.D., M.P.H.,

    1. Robert Wood Johnson Clinical Scholars Program, University of California at Los Angeles, Los Angeles, California
    2. Veterans Administration of Greater Los Angeles Healthcare System and the Department of Medicine, Los Angeles, California
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  • E. Richard Brown Ph.D.,

    1. Department of Health Services, University of California at Los Angeles Center for Health Policy Research and the University of California at Los Angeles School of Public Health, Los Angeles, California
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  • Clifford Y. Ko M.D., M.S., M.S.H.S.,

    1. Department of Surgery, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California
    2. Veterans Administration of Greater Los Angeles Healthcare System and the Department of Medicine, Los Angeles, California
    3. RAND, Santa Monica, California
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  • Neetu Chawla M.P.H.,

    1. Department of Health Services, University of California at Los Angeles Center for Health Policy Research and the University of California at Los Angeles School of Public Health, Los Angeles, California
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  • Nancy Breen Ph.D.,

    1. Health Services and Economics Branch, Applied Research Program, National Cancer Institute, Bethesda, Maryland
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  • Carrie N. Klabunde Ph.D.

    1. Health Services and Economics Branch, Applied Research Program, National Cancer Institute, Bethesda, Maryland
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Abstract

BACKGROUND

Recent research has supported the use of colorectal cancer (CRC) tests to reduce disease incidence, morbidity, and mortality. A new health survey has provided an opportunity to examine the use of these tests in California's ethnically diverse population. The authors used the 2001 California Health Interview Survey (CHIS 2001) to evaluate 1) rates of CRC test use, 2) predictors of the receipt of tests, and 3) reasons for nonuse of CRC tests.

METHODS

The CHIS 2001 is a random-digit dial telephone survey that was conducted in California. Responses were analyzed from 22,343 adults age ≥ 50 years. CRC test use was defined as receipt of a fecal occult blood test in the past year and/or receipt of an endoscopic examination in the past 5 years.

RESULTS

Nearly 54% of California adults reported receipt of a recent CRC test. Insurance coverage and having a usual source of care were the most important predictors of CRC testing. Latinos age < 65 years were less likely to be tested than whites (relative risk [RR], 0.84; 95% confidence interval [95% CI], 0.77–0.92). Men were more likely to be tested than women, an effect that was greater among individuals age 50–64 years (RR, 1.28; 95% CI, 1.23–1.32) than among individuals age ≥ 65 years (RR, 1.19; 95% CI, 1.15–1.23). Women were more likely than men to say that their physician did not inform them the test was needed and that CRC tests were painful or embarrassing.

CONCLUSIONS

Results of the current study indicate a need for physicians to recommend CRC testing to their patients. Assuring that all individuals have both health insurance and a usual source of care would help address gaps in the receipt of CRC tests. Cancer 2004. © 2004 American Cancer Society.

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