title: Improved rates of colorectal cancer screening in an equal access population.
abstract: BACKGROUND
  National colorectal cancer (CRC) screening averages 50% to 60%. We aimed to identify screening prevalence in select Department of Defense (DOD) beneficiaries with equal access to care.
  
  
  METHODS
  December 2007 cross-sectional data of patients over 50 years of age included patient demographics, screening modality, and compliance.
  
  
  RESULTS
  Of 17,252 patients (52% male; mean age 63.2 +/- 8.1 years), 12,229 (71%) were up-to-date with national screening guidelines. Modalities included colonoscopy (83.0%), flexible sigmoidoscopy with fecal occult blood testing (FOBT) (32.2%), and air-contrast barium enema (0.7%). African American or Hispanic background (70% African American, 68% Hispanic vs 73% Caucasian), younger patients (66.1% <65 years vs 78.6% >65 years), and male gender (69.9% vs 72.1%; all P < .001) all had lower rates. Compared to 2005, more patients were current with guidelines (71% vs 64%) and colonoscopic screening (83% vs 71%).
  
  
  CONCLUSIONS
  Although ethnicity-, gender-, and age-related disparities were observed, screening rates are improved in an equal access healthcare system.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Fort, Lewis, WA, USA.
authors.forename: Lionel R
authors.initials: LR
authors.lastname: Brounts
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Lehmann
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Lesperance
authors.forename: Tommy A
authors.initials: TA
authors.lastname: Brown
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001466:Barium Sulfate; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004733:Enema; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D008889:Military Personnel; D015995:Prevalence; D012812:Sigmoidoscopy / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D001466:Barium Sulfate