title: Colorectal cancer screening behavior and health insurance status (United States).
abstract: OBJECTIVE
  The purpose of this study was to examine the association between health insurance status and CRC screening behavior among a diverse sample of ambulatory patients.
  
  
  METHODS
  Cross-sectional, retrospective study. Quota sampling techniques were used to recruit 52 insured/uninsured patients > or =age 50 from three Midwestern medical clinics (N=104). Data were collected by interviewer-administered CRC screening questionnaires.
  
  
  RESULTS
  Thirty-nine percent of the sample was in compliance with CRC testing guidelines. Insured compared to uninsured participants were significantly more likely to have ever completed any testing (77% versus 33%), and were more likely to have undertaken testing according to current US guidelines (62% versus 17%), all ps < 0.001. Insured participants also were significantly more likely than the uninsured to know about, receive physician recommendation to screen, and profess future intent to screen, ps < 0.001. Fewer uninsured participants were tested for routine reasons compared to insured participants. Significant group differences did not emerge on future preference for a particular screening methodology, if testing costs were equal.
  
  
  CONCLUSIONS
  Results suggest that CRC screening depends, in part, on health insurance status. Increasing insurance coverage or resources for low-cost, accurate tests may facilitate future screening.
authors.affiliation: Medical College of Wisconsin, Health Policy Institute, Center for Patient Care and Outcomes Research, Suite H2755, 8701 Watertown Plank Road, PO Box 26509, Milwaukee, WI 53226-0509, USA. amatthew@mcw.edu
authors.forename: B Alex
authors.initials: BA
authors.lastname: Matthews
authors.forename: Ruric C
authors.initials: RC
authors.lastname: Anderson
authors.forename: Ann B
authors.initials: AB
authors.lastname: Nattinger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D012812:Sigmoidoscopy / Q000706:statistics & numerical data; D012959:Socioeconomic Factors