*EMBARGOED All research presented at the World Congress of Gastroenterology at ACG2017 is strictly embargoed until Monday, October 16, 2017, at 8:00 am EDT.
Poster 1569 Colorectal Cancer Screening Utilization in U.S. Colorectal Cancer Hotspots
Author Insight from Jannel Lee-Allen, MD, MUP, and Darrell M. Gray, II, MD, MPH, The Ohio State University Wexner Medical Center
What’s new here and important for clinicians?
It is well established that colorectal cancer (CRC) is the leading gastrointestinal cause of
death and that the burden of disease is not equally distributed across the United States. Further, there are three “hotspots” with excessive death rates in which targeted screening programs may have great impact, including the Lower Mississippi Delta, West Central Appalachia, and Eastern Virginia/North Carolina. We explored this premise by examining Medicare data from these hotspots with the aim of comparing the volume of endoscopy-based screening (EBS) and reimbursement for EBS between hotspots and the rest of the United States. Interestingly, we found that there is more EBS in hotspots compared to non-hotspots and that reimbursements are similar between the two. Of note, our study was limited to the Medicare population, but suggests that, while screening has played a significant role in the decline in CRC mortality over time, the primary cause for geographic disparities in colorectal cancer deaths may not be differences in access to, or utilization of, EBS.
What do patients need to know?
CRC outcomes are influenced by multiple factors, screening and geography being two for which we have strong evidence. However, our data suggests that within “hotspots,” regions with excessive CRC deaths, there are other factors aside from access to and uptake of screening that were not captured in our analysis that contribute to geographic disparities. Further investigation is necessary. Such research can have significant policy and clinical implications.
Primary Author Jannel Lee-Allen, MD, MUP
Senior Author Darrell M. Gray, II, MD, MPH
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