title: Communication and colorectal cancer screening among the uninsured: data from the Health Information National Trends Survey (United States).
abstract: OBJECTIVE
  Colorectal cancer screening allows for both prevention and early detection of the disease, with early detection often resulting in improved prognosis. Too few Americans over 50 are screened for colorectal cancer, but among certain subpopulations screening rates are particularly low for various reasons. We examined the role of communication factors and insurance, with a specific focus on the uninsured to examine disparities in colorectal cancer screening.
  
  
  METHODS
  We used Health Information National Trends Survey data to examine: disparities in colorectal cancer screening, by calculating proportions of subpopulations screened; and the association between communication and screening among the uninsured, by performing chi-square tests and simple logistic regression to examine the potential factors associated with screening.
  
  
  RESULTS
  The uninsured were 64% less likely to be screened than the insured. Provider recommendation was the only significant communication measure, with the uninsured lacking a recommendation 98.5% less likely to be screened than those with one.
  
  
  CONCLUSIONS
  These data suggest expansion of programs of screening among the uninsured and more aggressive communication campaigns to promote the awareness and provider recommendation of screening as possible ways to increase screening and reduce mortality of colorectal cancer.
authors.affiliation: Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA 02115, USA. ccairns@bphc.org
authors.forename: Catherine P
authors.initials: CP
authors.lastname: Cairns
authors.forename: K
authors.initials: K
authors.lastname: Viswanath
mesh_terms: D001071:Appointments and Schedules; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D003142:Communication; D015986:Confounding Factors, Epidemiologic; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D017057:Medically Uninsured; D008875:Middle Aged; D009780:Occult Blood; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011369:Professional-Patient Relations; D012107:Research Design; D014481:United States / Q000453:epidemiology