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NIH panel pushes for more CRC screenings
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A National Institutes of Health (NIH) consensus panel found that more
needs to be done to reduce the colorectal cancer deaths by striking
down barriers to screening.
Leonard E. Egede, M.D., professor of medicine, served on the panel.
Egede said there is a need to get this information out to educate
people about all the tests available and the importance of having them
done.
Colorectal cancer (CRC) is the second leading cause of cancer-related
deaths in the United States. Despite evidence and guidelines supporting
the value of screening for this disease, rates of screening for
colorectal cancer are consistently lower than those for other types of
cancer, particularly breast and cervical. Although the screening rates
in the target population of adults over age 50 have increased from
20-30 percent in 1997 to nearly 55 percent in 2008, the rates still are
too low.
In 2008, about 55 percent of Americans, 50 years and older, had been
screened for CRC, which compares unfavorably to the 70 to 80 percent
seen in some other cancers.
The Centers for Disease Control and Prevention (CDC) is implementing a
$100 million program that features free CRC screening services to
low-income people, 50 to 64 years of age, who are underinsured or
uninsured in 22 states and four tribal organizations. The CDC’s goal is
to have 80 percent of those 50 years and older who are covered by the
program screened within five years.
“It’s a wonderful program, but its reach is limited,” said Egede about
the CDC’s efforts. The aim of the NIH conference is broader than the
CDC’s program and seeks to increase participation in the general
population, not just among the underinsured or uninsured in select
locales, Egede said.
The panel found that the most important factors associated with being
screened are having insurance coverage and access to a regular health
care provider. Its recommendations highlighted the need to remove
out-of-pocket costs for screening tests. Given the variety of tests
available, the panel emphasized that informed decisions incorporating
personal preferences may help reluctant individuals determine which
test’s combined attributes—invasiveness, frequency, and required
preparation—are preferable to them, helping them identify and obtain
the most palatable test.
For example, an individual may choose a more invasive test requiring
less frequent follow-up or a less invasive test requiring more frequent
follow-up. Noting differences in screening rates across racial and
ethnic groups, socioeconomic status, and geographic location, the panel
emphasized the need for targeted strategies for specific
subgroups.
Compared with non-Hispanic whites, Hispanics are less likely to be screened.
A summary of the panel’s findings is available in the panel’s draft statement at http://consensus.nih.gov/2010/colorectalmedia.htm.
Friday, March 5, 2010
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