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Effects of the Colorectal Cancer Control Program.

Marianne P Bitler1, Christopher S Carpenter2, Danea Horn3

  • 1Department of Economics, UC Davis, NBER, and IZA, Davis, CA, USA.

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|August 3, 2021
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The Colorectal Cancer Control Program (CRCCP) increased endoscopic colorectal cancer (CRC) screening for uninsured adults, particularly women and minorities. However, it did not significantly impact CRC detection rates.

Keywords:
CRCCPcolorectal cancer screenings

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Area of Science:

  • Public Health
  • Cancer Prevention
  • Health Services Research

Background:

  • Colorectal cancer (CRC) screening is crucial but underutilized, especially among low-income populations.
  • Low screening rates persist despite the effectiveness of available screening methods.

Purpose of the Study:

  • To evaluate the impact of the Colorectal Cancer Control Program (CRCCP) on CRC screening rates.
  • To assess the effectiveness of CRCCP interventions among vulnerable, low-income, uninsured populations.

Main Methods:

  • Utilized a difference-in-differences strategy with data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2001-2015.
  • Analyzed the effects of CRCCP grants on the uptake of fecal occult blood tests (FOBT) and endoscopic screenings (sigmoidoscopy, colonoscopy).

Main Results:

  • CRCCP did not significantly affect the use of fecal occult blood tests (FOBT).
  • CRCCP significantly increased endoscopic CRC screening (sigmoidoscopy or colonoscopy) by 2.9 percentage points (10.7%) among uninsured individuals aged 50-64.
  • Observed larger effects in women, minorities, and those not receiving other preventive care; no significant changes in CRC detection were found.

Conclusions:

  • The CRCCP effectively increased CRC screening rates, particularly endoscopic screening, among vulnerable, low-income, uninsured populations.
  • Programmatic efforts can improve screening uptake in underserved groups, though impact on cancer detection requires further study.