TY - JOUR
T1 - Initiation of Colorectal Cancer Screening Among Medicaid Enrollees
AU - Mojica, Cynthia M.
AU - Bradley, Savannah M.
AU - Lind, Bonnie K.
AU - Gu, Yifan
AU - Coronado, Gloria D.
AU - Davis, Melinda M.
N1 - Funding Information:
The content is solely the responsibility of the authors and does not necessarily represent the official views of the Knight Cancer Institute or NIH. Neither of the study sponsors had any role in the study design, data collection, data analysis, interpretation of findings, writing of the manuscript, or in the decision to submit this manuscript for publication. The study was supported by the Knight Cancer Institute-Oregon Health & Sciences University/Oregon State University Cancer Prevention and Control Initiative. Dr. Davis is supported by a Cancer Prevention, Control, Behavioral Sciences, and Populations Sciences Career Development Award from the National Cancer Institute (K07CA211971). CMM and MMD contributed to the study design, statistical analyses, and interpretation of findings. BL and YG conducted data management and performed all statistical analyses. SMB contributed to manuscript preparation and data collection. GDC contributed to interpretation of findings. All authors helped with writing and critical revision of the manuscript. From November 2014 to August 2015, Kaiser Permanente Northwest Center for Health Research (KPCHR; GDC served as a co-investigator) participated in an industry-funded study to evaluate patient adherence to an experimental blood test for colorectal cancer. The study was funded by EpiGenomics. From September 2017 to June 2018, KPCHR (GDC served as the principal investigator) participated in an industry-funded study to compare the clinical performance of an experimental fecal immunochemical test (FIT) to an FDA-approved FIT. This study was funded by Quidel Corporation. No other financial disclosures were reported by the authors of this paper.
Funding Information:
The content is solely the responsibility of the authors and does not necessarily represent the official views of the Knight Cancer Institute or NIH. Neither of the study sponsors had any role in the study design, data collection, data analysis, interpretation of findings, writing of the manuscript, or in the decision to submit this manuscript for publication. The study was supported by the Knight Cancer Institute-Oregon Health & Sciences University/Oregon State University Cancer Prevention and Control Initiative. Dr. Davis is supported by a Cancer Prevention, Control, Behavioral Sciences, and Populations Sciences Career Development Award from the National Cancer Institute (K07CA211971). CMM and MMD contributed to the study design, statistical analyses, and interpretation of findings. BL and YG conducted data management and performed all statistical analyses. SMB contributed to manuscript preparation and data collection. GDC contributed to interpretation of findings. All authors helped with writing and critical revision of the manuscript. From November 2014 to August 2015, Kaiser Permanente Northwest Center for Health Research (KPCHR; GDC served as a co-investigator) participated in an industry-funded study to evaluate patient adherence to an experimental blood test for colorectal cancer. The study was funded by EpiGenomics. From September 2017 to June 2018, KPCHR (GDC served as the principal investigator) participated in an industry-funded study to compare the clinical performance of an experimental fecal immunochemical test (FIT) to an FDA-approved FIT. This study was funded by Quidel Corporation. No other financial disclosures were reported by the authors of this paper.
PY - 2020/2
Y1 - 2020/2
N2 - Introduction: Few studies have explored how individual- and practice-level factors influence colorectal cancer screening initiation among Medicaid enrollees newly age eligible for colorectal cancer screening (i.e., turning 50 years). This study explored colorectal cancer screening initiation among newly age-eligible Medicaid enrollees in Oregon. Methods: Medicaid claims data (January 2013 to June 2015) were used to conduct multivariable logistic regression (in 2018 and 2019) to explore individual- and practice-level factors associated with colorectal cancer screening initiation among 9,032 Medicaid enrollees. Results: A total of 17% of Medicaid enrollees initiated colorectal cancer screening; of these, 64% received a colonoscopy (versus fecal testing). Colorectal cancer screening initiation was positively associated with turning 50 years in 2014 (versus 2013; OR=1.21), being Hispanic (versus non-Hispanic white; OR=1.41), urban residence (versus rural; OR=1.23), and having 4 to 7 (OR=1.90) and 8 or more (OR=2.64) primary care visits compared with 1 to 3 visits in the year after turning 50 years. Having 3 or more comorbidities was inversely associated with initiation (OR=0.75). The odds of screening initiation were also higher for practices with 3 to 4 (OR=1.26) and 8 or more (OR=1.34) providers compared with 1 to 2 providers, and negatively associated with percentage of Medicaid panel age eligible for colorectal cancer screening (OR=0.92). Conclusions: Both individual- and practice-level factors are associated with disparities in colorectal cancer screening initiation among Oregon Medicaid enrollees. Future work promoting colorectal cancer screening might focus on additional barriers to the timely initiation of colorectal cancer screening and explore the effect of practice in-reach and population outreach strategies.
AB - Introduction: Few studies have explored how individual- and practice-level factors influence colorectal cancer screening initiation among Medicaid enrollees newly age eligible for colorectal cancer screening (i.e., turning 50 years). This study explored colorectal cancer screening initiation among newly age-eligible Medicaid enrollees in Oregon. Methods: Medicaid claims data (January 2013 to June 2015) were used to conduct multivariable logistic regression (in 2018 and 2019) to explore individual- and practice-level factors associated with colorectal cancer screening initiation among 9,032 Medicaid enrollees. Results: A total of 17% of Medicaid enrollees initiated colorectal cancer screening; of these, 64% received a colonoscopy (versus fecal testing). Colorectal cancer screening initiation was positively associated with turning 50 years in 2014 (versus 2013; OR=1.21), being Hispanic (versus non-Hispanic white; OR=1.41), urban residence (versus rural; OR=1.23), and having 4 to 7 (OR=1.90) and 8 or more (OR=2.64) primary care visits compared with 1 to 3 visits in the year after turning 50 years. Having 3 or more comorbidities was inversely associated with initiation (OR=0.75). The odds of screening initiation were also higher for practices with 3 to 4 (OR=1.26) and 8 or more (OR=1.34) providers compared with 1 to 2 providers, and negatively associated with percentage of Medicaid panel age eligible for colorectal cancer screening (OR=0.92). Conclusions: Both individual- and practice-level factors are associated with disparities in colorectal cancer screening initiation among Oregon Medicaid enrollees. Future work promoting colorectal cancer screening might focus on additional barriers to the timely initiation of colorectal cancer screening and explore the effect of practice in-reach and population outreach strategies.
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U2 - 10.1016/j.amepre.2019.09.015
DO - 10.1016/j.amepre.2019.09.015
M3 - Article
C2 - 31786031
AN - SCOPUS:85076090188
VL - 58
SP - 224
EP - 231
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
SN - 0749-3797
IS - 2
ER -