Health plan policies and programs for colorectal cancer screening: a national profile.
BACKGROUND
A consensus has emerged that average-risk adults 50 years of age or older should be screened for colorectal cancer (CRC).


OBJECTIVE
To describe health plans' coverage policies, guidelines, and organized programs to promote CRC screening.


METHODS
Review of data from the National Cancer Institute Survey of Colorectal Cancer Screening Practices, administered to a national sample of health plans in 1999-2000. The survey inquired about coverage policies for fecal occult blood testing, sigmoidoscopy, colonoscopy, and double-contrast barium enema; the nature of any guidelines the plan had issued to its providers on CRC screening; and systems for recruiting patients into screening and for tracking and reporting the results of screening and follow-up procedures.


RESULTS
Of 346 eligible health plans, 180 (52%) responded. Nearly all health plans covered at least 1 CRC screening modality. Plans were most likely to cover fecal occult blood testing (97%) and least likely to cover colonoscopy (57%). Sixty-five percent had issued guidelines on CRC screening to providers. One quarter had a mechanism to remind patients that they are due for CRC screening, but fewer had systems for prompting providers, contacting noncompliant patients, or tracking completion of screening.


CONCLUSIONS
Health plans have the ability to provide organizational infrastructure for a broad range of preventive services to well-defined populations. However, few health plans had all 3 essential CRC screening delivery components--coverage, guidelines, and tracking systems--in place in 1999-2000.
Klabunde
Carrie N
CN
Division of Cancer Control and Population Sciences, National Cancer Institute (NCI), Executive Plaza North Room 4005, 6130 Executive Boulevard, Bethesda, MD 20892-7344, USA. ck97b@nih.gov
Riley
Gerald F
GF
Mandelson
Margaret T
MT
Frame
Paul S
PS
Brown
Martin L
ML
D000068:Accreditation; D002204:Capitation Fee; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D019458:Insurance Coverage / Q000458:organization & administration*; D007348:Insurance, Health / Q000706:statistics & numerical data; D008403:Mass Screening / Q000458:organization & administration*; D008484:Medicaid; D006278:Medicare; D017146:Models, Organizational; D016134:Organizational Policy; D010067:Ownership; D017410:Practice Guidelines as Topic; D011314:Preventive Health Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D014481:United States