Colorectal cancer screening behavior and health insurance status (United States)

The purpose of this study was to examine the association between health insurance status and CRC screening behavior among a diverse sample of ambulatory patients.

Cross-sectional, retrospective study. Quota sampling techniques were used to recruit 52 insured/uninsured patients > or =age 50 from three Midwestern medical clinics (N=104). Data were collected by interviewer-administered CRC screening questionnaires.

Thirty-nine percent of the sample was in compliance with CRC testing guidelines. Insured compared to uninsured participants were significantly more likely to have ever completed any testing (77% versus 33%), and were more likely to have undertaken testing according to current US guidelines (62% versus 17%), all ps < 0.001. Insured participants also were significantly more likely than the uninsured to know about, receive physician recommendation to screen, and profess future intent to screen, ps < 0.001. Fewer uninsured participants were tested for routine reasons compared to insured participants. Significant group differences did not emerge on future preference for a particular screening methodology, if testing costs were equal.

Results suggest that CRC screening depends, in part, on health insurance status. Increasing insurance coverage or resources for low-cost, accurate tests may facilitate future screening.