Use of Colonoscopy for Colorectal Cancer Screening: Evidence from the 2000 National Health Interview Survey

Abstract

Background: The use of colonoscopy as a primary screening tool for colorectal cancer is gaining momentum owing to several studies suggesting superior effectiveness and the recent, favorable decision by Medicare to cover all routine screening colonoscopies. This study documents the use of colonoscopy versus other tests to screen for colorectal cancer. Materials and Methods: Data from the 2000 National Health Interview Survey were analyzed. Fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy done for any reason and for routine screening only were analyzed for those z z À 50 years without previously diagnosed colorectal cancer (n = 12,505). Results: The proportion of the total eligible population receiving any of the recommended tests for all possible reasons and for screening purposes only is 34.6% and 25.1%, respectively. For routine screening purposes, the test most

Alarm symptoms, risk factors for digestive tract cancer and readiness to participate in an endoscopic screening program

“…Smokers declared almost twice as low readiness for screening, which may have its roots in their lifestyle associated with a more nihilistic attitude toward health. Similar conclusions were drawn by American authors, who found that smokers and alcohol abusers are less eager to participate in screening [34,35]. These observations lead to the conclusion that a great er emphasis should be placed on the need to screen men, obese persons, smokers and alcohol abusers.…”

Colorectal Tumors Within an Urban Minority Population in New York City

“…According to US national estimates, only 31% of Hispanics undergo either colonoscopy or sigmoidoscopy as screening procedure for colorectal cancer compared to 35% African Americans and 39% Whites. 12 Of all subjects who underwent colonoscopy in our study, a majority of them (85%) were Hispanics. This represents colorectal cancer screening in an estimated 21% of our eligible Hispanic American subjects by colonoscopy alone.…”

“…12 The reported rate of screening for colorectal cancer by colonoscopy in adult practice settings is only about 12.5%. 14 Using the system interventions described earlier, the overall colorectal screening coverage provided by our facility among persons aged 50 and over in surrounding ZIP codes increased from 5.2% to 15.6%.…”

“…US national estimates of gastrointestinal endoscopy rates among Hispanics have been reported to be higher than African Americans. 12 Target population studies have shown that Hispanic women are engaged in relatively high level of cancer preventive behavior, even though their knowledge was limited. Many of these subjects have poor insight regarding cancer, which impacts on preventive behaviors.…”

Risk of Proximal Colonic Neoplasms in Asymptomatic Adults Older Than 50 Years Found to Have Distal Hyperplastic Polyps on Routine Colorectal Cancer Screening

“…Presently, there are five advocated options for elective screening in asymptomatic patients: 1) yearly stool testing for occult blood starting at age 50, 2) an air-contrast barium enema of the large bowel at age 50 and every five years thereafter if the findings are normal, 3) flexible sigmoidoscopy (FS) at age 50 and every five years thereafter if the findings are normal, 4) computed tomography colonography at age 50 and every five years thereafter if the findings are normal, and 5) colonoscopy at age 50 and every ten years thereafter if the findings are normal. 2,3 The main focus of this analysis revolved around the use of FS within this asymptomatic screening population, and specifically, whether further evaluation (colonoscopy) should be considered in patients found to have distal hyperplastic…”