title: Colorectal cancer screening use among insured primary care patients.
abstract: OBJECTIVE
  To compare colorectal cancer (CRC) screening use, including changes over time and demographic characteristics associated with screening receipt, between 2 insured primary care populations.
  
  
  METHODS
  Clinical and administrative records from 2 large health systems, one in New Mexico and the other in Michigan, were used to determine use of CRC screening tests between 2004 and 2008 among patients aged 51 to 74 years.
  
  
  METHODS
  Generalized estimating equations were used to evaluate trends in CRC screening use over time and the association of demographic and other factors with screening receipt.
  
  
  RESULTS
  Rates of CRC screening use ranged from 48.1% at the New Mexico site to 68.7% at the Michigan site, with colonoscopy being the most frequently used modality. Fecal occult blood test was used inconsistently by substantial proportions of patients who did not meet the definition of screening users. Screening use was positively and significantly associated with older age, male sex, and more periodic health examinations and other types of primary care visits; at the Michigan site, it was also associated with African American race, married status, and higher annual estimated household income.
  
  
  CONCLUSIONS
  Among insured primary care patients, CRC screening use falls short. Further research is needed to determine what factors are barriers to routine fecal occult blood test or colonoscopy use among insured patients who have access to and regularly use primary care and how those barriers can be eliminated.
authors.affiliation: Center for Health Services Research, Henry Ford Health System, Detroit, MI 48202, USA. dshires1@hfhs.org
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Shires
authors.forename: George
authors.initials: G
authors.lastname: Divine
authors.forename: Michael
authors.initials: M
authors.lastname: Schum
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Gunter
authors.forename: Dorothy L
authors.initials: DL
authors.lastname: Baumer
authors.forename: Danuta
authors.initials: D
authors.lastname: Kasprzyk
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Montano
authors.forename: Judith Lee
authors.initials: JL
authors.lastname: Smith
authors.forename: Jennifer
authors.initials: J
authors.lastname: Elston-Lafata
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D003113:Colonoscopy / Q000191:economics / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics; D055088:Early Detection of Cancer / Q000191:economics / Q000706:statistics & numerical data; D005006:Ethnicity; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D017533:Marital Status; D008824:Michigan; D008875:Middle Aged; D009516:New Mexico; D012959:Socioeconomic Factors