A population-based study of colorectal cancer test use: results from the 2001 California Health Interview Survey.
BACKGROUND
Recent research has supported the use of colorectal cancer (CRC) tests to reduce disease incidence, morbidity, and mortality. A new health survey has provided an opportunity to examine the use of these tests in California's ethnically diverse population. The authors used the 2001 California Health Interview Survey (CHIS 2001) to evaluate 1) rates of CRC test use, 2) predictors of the receipt of tests, and 3) reasons for nonuse of CRC tests.


METHODS
The CHIS 2001 is a random-digit dial telephone survey that was conducted in California. Responses were analyzed from 22,343 adults age >/= 50 years. CRC test use was defined as receipt of a fecal occult blood test in the past year and/or receipt of an endoscopic examination in the past 5 years.


RESULTS
Nearly 54% of California adults reported receipt of a recent CRC test. Insurance coverage and having a usual source of care were the most important predictors of CRC testing. Latinos age < 65 years were less likely to be tested than whites (relative risk [RR], 0.84; 95% confidence interval [95% CI], 0.77-0.92). Men were more likely to be tested than women, an effect that was greater among individuals age 50-64 years (RR, 1.28; 95% CI, 1.23-1.32) than among individuals age >/= 65 years (RR, 1.19; 95% CI, 1.15-1.23). Women were more likely than men to say that their physician did not inform them the test was needed and that CRC tests were painful or embarrassing.


CONCLUSIONS
Results of the current study indicate a need for physicians to recommend CRC testing to their patients. Assuring that all individuals have both health insurance and a usual source of care would help address gaps in the receipt of CRC tests.
Etzioni
David A
DA
Department of Surgery, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California, USA.
Ponce
Ninez A
NA
Babey
Susan H
SH
Spencer
Benjamin A
BA
Brown
E Richard
ER
Ko
Clifford Y
CY
Chawla
Neetu
N
Breen
Nancy
N
Klabunde
Carrie N
CN
D000368:Aged; D002140:California; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009780:Occult Blood; D010353:Patient Education as Topic; D012307:Risk Factors; D012737:Sex Factors