The role of health insurance coverage in cancer screening utilization.
BACKGROUND
Although previous studies have shown a correlation between health insurance coverage and cancer screening, underinsurance and cancer screening among racial/ethnic minorities has not been examined.


METHODS
Data from the 2000 and 2003 National Health Interview Surveys are used in this analysis. Cross-tabulations, age, and racial/ethnic group stratified regression analyses are used to examine associations between health insurance status and receipt of mammography, Pap testing, prostate specific antigen tests, fecal occult blood test (FOBT) and colorectal endoscopy.


RESULTS
In overall models, uninsurance was associated with lower receipt of all tests except FOBT among participants ages 65-85 years. Underinsurance was associated with lower receipt of mammography among women under 65 years only.


CONCLUSIONS
These findings show age variation in the association between cancer screening and health insurance coverage. In addition, health insurance appears to act similarly across racial/ethnic groups. Further examination of underinsurance in cancer screening utilization and other health behaviors is needed.
Robinson
JaMuir M
JM
Cancer Prevention and Fellowship Program, Division of Cancer Prevention and Office of Education and Special Initiatives, National Cancer Institute, 6116 Executive Blvd., Ste. 202, Bethesda, MD 20892, USA. robinjam@mail.nih.gov
Shavers
Vickie
V
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000517:prevention & control; D003113:Colonoscopy / Q000191:economics / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000517:prevention & control; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000208:ethnology* / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000208:ethnology / Q000517:prevention & control*; D009780:Occult Blood; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000517:prevention & control; D012737:Sex Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears / Q000191:economics / Q000706:statistics & numerical data
D017430:Prostate-Specific Antigen