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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.
Health Economics
|August 3, 2021
Summary
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.
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.
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