Influence of health insurance coverage on breast, cervical, and colorectal cancer screening in rural primary care settings

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

BACKGROUND: The current study was performed to determine, in rural settings, the relation between the type and status of insurance coverage and being up-to-date for breast, cervical, and colorectal cancer screening. METHODS: Four primary care practices in 2 rural Oregon communities participated. Medical chart reviews that were conducted between October 2008 and August 2009 assessed insurance coverage and up-to-date status for breast, cervical, and colorectal cancer screening. Inclusion criteria involved having at least 1 health care visit within the past 5 years and being aged ≥ 55 years. RESULTS: The majority of patients were women aged 55 years to 70 years, employed or retired, and who had private health insurance and an average of 2.5 comorbid conditions. The overall percentage of eligible women who were up-to-date for cervical cancer screening was 30%; approximately 27% of women were up-to-date for clinical breast examination, 37% were up-to-date for mammography, and 19% were up-to-date for both mammography and clinical breast examination. Approximately 38% of men and 35% of women were up-to-date for colorectal cancer screening using any test at appropriate screening intervals. In general, having any insurance versus being uninsured was associated with undergoing cancer screening. For each type of screening, patients who had at least 1 health maintenance visit were significantly more likely to be up-to-date compared with those with no health maintenance visits. A significant interaction was found between having health maintenance visits, having any health insurance, and being up-to-date for cancer screening tests. CONCLUSIONS: Overall, the percentage of patients who were up-to-date for any cancer screening, especially cervical cancer screening, was found to be very low in rural Oregon. Patients with some form of health insurance were more likely to have had a health maintenance visit within the previous 2 years and to be up-to-date for breast, cervical, and/or colorectal cancer screening.

Original languageEnglish (US)
Pages (from-to)6217-6225
Number of pages9
JournalCancer
Volume118
Issue number24
DOIs
StatePublished - Dec 15 2012

Fingerprint

Insurance Coverage
Health Insurance
Early Detection of Cancer
Uterine Cervical Neoplasms
Colorectal Neoplasms
Primary Health Care
Breast Neoplasms
Health
Mammography
Breast
Rural Population
Insurance
Delivery of Health Care

Keywords

  • cancer screening
  • colonoscopy
  • health insurance
  • mammography
  • Papanicolaou (Pap) test

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{a1b41561cf124eb8bb29e0c9cd5e5e91,
title = "Influence of health insurance coverage on breast, cervical, and colorectal cancer screening in rural primary care settings",
abstract = "BACKGROUND: The current study was performed to determine, in rural settings, the relation between the type and status of insurance coverage and being up-to-date for breast, cervical, and colorectal cancer screening. METHODS: Four primary care practices in 2 rural Oregon communities participated. Medical chart reviews that were conducted between October 2008 and August 2009 assessed insurance coverage and up-to-date status for breast, cervical, and colorectal cancer screening. Inclusion criteria involved having at least 1 health care visit within the past 5 years and being aged ≥ 55 years. RESULTS: The majority of patients were women aged 55 years to 70 years, employed or retired, and who had private health insurance and an average of 2.5 comorbid conditions. The overall percentage of eligible women who were up-to-date for cervical cancer screening was 30{\%}; approximately 27{\%} of women were up-to-date for clinical breast examination, 37{\%} were up-to-date for mammography, and 19{\%} were up-to-date for both mammography and clinical breast examination. Approximately 38{\%} of men and 35{\%} of women were up-to-date for colorectal cancer screening using any test at appropriate screening intervals. In general, having any insurance versus being uninsured was associated with undergoing cancer screening. For each type of screening, patients who had at least 1 health maintenance visit were significantly more likely to be up-to-date compared with those with no health maintenance visits. A significant interaction was found between having health maintenance visits, having any health insurance, and being up-to-date for cancer screening tests. CONCLUSIONS: Overall, the percentage of patients who were up-to-date for any cancer screening, especially cervical cancer screening, was found to be very low in rural Oregon. Patients with some form of health insurance were more likely to have had a health maintenance visit within the previous 2 years and to be up-to-date for breast, cervical, and/or colorectal cancer screening.",
keywords = "cancer screening, colonoscopy, health insurance, mammography, Papanicolaou (Pap) test",
author = "Carney, {Patricia (Patty)} and Jean O'Malley and David Buckley and Mori, {Motomi (Tomi)} and David Lieberman and Lyle Fagnan and James Wallace and Betty Liu and Cynthia Morris",
year = "2012",
month = "12",
day = "15",
doi = "10.1002/cncr.27635",
language = "English (US)",
volume = "118",
pages = "6217--6225",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "24",

}

TY - JOUR

T1 - Influence of health insurance coverage on breast, cervical, and colorectal cancer screening in rural primary care settings

AU - Carney, Patricia (Patty)

AU - O'Malley, Jean

AU - Buckley, David

AU - Mori, Motomi (Tomi)

AU - Lieberman, David

AU - Fagnan, Lyle

AU - Wallace, James

AU - Liu, Betty

AU - Morris, Cynthia

PY - 2012/12/15

Y1 - 2012/12/15

N2 - BACKGROUND: The current study was performed to determine, in rural settings, the relation between the type and status of insurance coverage and being up-to-date for breast, cervical, and colorectal cancer screening. METHODS: Four primary care practices in 2 rural Oregon communities participated. Medical chart reviews that were conducted between October 2008 and August 2009 assessed insurance coverage and up-to-date status for breast, cervical, and colorectal cancer screening. Inclusion criteria involved having at least 1 health care visit within the past 5 years and being aged ≥ 55 years. RESULTS: The majority of patients were women aged 55 years to 70 years, employed or retired, and who had private health insurance and an average of 2.5 comorbid conditions. The overall percentage of eligible women who were up-to-date for cervical cancer screening was 30%; approximately 27% of women were up-to-date for clinical breast examination, 37% were up-to-date for mammography, and 19% were up-to-date for both mammography and clinical breast examination. Approximately 38% of men and 35% of women were up-to-date for colorectal cancer screening using any test at appropriate screening intervals. In general, having any insurance versus being uninsured was associated with undergoing cancer screening. For each type of screening, patients who had at least 1 health maintenance visit were significantly more likely to be up-to-date compared with those with no health maintenance visits. A significant interaction was found between having health maintenance visits, having any health insurance, and being up-to-date for cancer screening tests. CONCLUSIONS: Overall, the percentage of patients who were up-to-date for any cancer screening, especially cervical cancer screening, was found to be very low in rural Oregon. Patients with some form of health insurance were more likely to have had a health maintenance visit within the previous 2 years and to be up-to-date for breast, cervical, and/or colorectal cancer screening.

AB - BACKGROUND: The current study was performed to determine, in rural settings, the relation between the type and status of insurance coverage and being up-to-date for breast, cervical, and colorectal cancer screening. METHODS: Four primary care practices in 2 rural Oregon communities participated. Medical chart reviews that were conducted between October 2008 and August 2009 assessed insurance coverage and up-to-date status for breast, cervical, and colorectal cancer screening. Inclusion criteria involved having at least 1 health care visit within the past 5 years and being aged ≥ 55 years. RESULTS: The majority of patients were women aged 55 years to 70 years, employed or retired, and who had private health insurance and an average of 2.5 comorbid conditions. The overall percentage of eligible women who were up-to-date for cervical cancer screening was 30%; approximately 27% of women were up-to-date for clinical breast examination, 37% were up-to-date for mammography, and 19% were up-to-date for both mammography and clinical breast examination. Approximately 38% of men and 35% of women were up-to-date for colorectal cancer screening using any test at appropriate screening intervals. In general, having any insurance versus being uninsured was associated with undergoing cancer screening. For each type of screening, patients who had at least 1 health maintenance visit were significantly more likely to be up-to-date compared with those with no health maintenance visits. A significant interaction was found between having health maintenance visits, having any health insurance, and being up-to-date for cancer screening tests. CONCLUSIONS: Overall, the percentage of patients who were up-to-date for any cancer screening, especially cervical cancer screening, was found to be very low in rural Oregon. Patients with some form of health insurance were more likely to have had a health maintenance visit within the previous 2 years and to be up-to-date for breast, cervical, and/or colorectal cancer screening.

KW - cancer screening

KW - colonoscopy

KW - health insurance

KW - mammography

KW - Papanicolaou (Pap) test

UR - http://www.scopus.com/inward/record.url?scp=84870685192&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870685192&partnerID=8YFLogxK

U2 - 10.1002/cncr.27635

DO - 10.1002/cncr.27635

M3 - Article

C2 - 22648383

AN - SCOPUS:84870685192

VL - 118

SP - 6217

EP - 6225

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 24

ER -