Journal of the National Cancer Institute
Volume 106, Issue 4, 2014

Challenges and possible solutions to colorectal cancer screening for the underserved (Review) (Open Access)

Gupta S.* , Sussman D.A. , Doubeni C.A. , Anderson D.S. , Day L. , Deshpande A.R. , Joseph Elmunzer B. , Laiyemo A.O. , Mendez J. , Somsouk M. , Allison J. , Bhuket T. , Geng Z. , Green B.B. , Itzkowitz S.H. , Martinez M.E.
  • a Department of Internal Medicine, University of California San Diego, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Dr MC 111D, San Diego, CA 92161, United States, University of California San Diego Moores Cancer Center, San Diego, CA, United States
  • b Division of Gastroenterology, Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, United States, Southern California Kaiser Permanente Group, San Diego, CA, United States
  • c Department of Family Medicine and Community Health at the Perelman School of Medicine, Center for Clinical Epidemiology and Biostatistics, Leonard Davis Institute for Health Economics, Philadelphia, PA, United States, Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, United States
  • d [Affiliation not available]
  • e San Francisco General Hospital, University of California San Francisco, San Francisco, CA, United States
  • f Division of Gastroenterology, Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
  • g Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, United States
  • h Division of Gastroenterology, Department of Medicine, Howard University, Washington, DC, United States
  • i MD Incorporated, Encinitas, CA, United States
  • j San Francisco General Hospital, University of California San Francisco, San Francisco, CA, United States
  • k San Francisco General Hospital, University of California San Francisco, San Francisco, CA, United States, Kaiser Northern California Division of Research, Oakland, CA, United States
  • l Alameda County Medical Center, Oakland, CA, United States
  • m University of Texas Southwestern Medical School, Dallas, TX, United States
  • n Group Health Research Institute, Seattle, WA, United States
  • o Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • p University of California San Diego Moores Cancer Center, San Diego, CA, United States, Department of Family and Preventive Medicine, University of California San Diego, San Diego, CA, United States

Abstract

Colorectal cancer (CRC) is a leading cause of cancer mortality worldwide. CRC incidence and mortality can be reduced through screening. However, in the United States, screening participation remains suboptimal, particularly among underserved populations such as the uninsured, recent immigrants, and racial/ethnic minority groups. Increasing screening rates among underserved populations will reduce the US burden of CRC. In this commentary focusing on underserved populations, we highlight the public health impact of CRC screening, list key challenges to screening the underserved, and review promising approaches to boost screening rates. We identify four key policy and research priorities to increase screening among underserved populations: 1) actively promote the message, "the best test is the one that gets done"; 2) develop and implement methods to identify unscreened individuals within underserved population groups for screening interventions; 3) develop and implement approaches for organized screening delivery; and 4) fund and enhance programs and policies that provide access to screening, diagnostic follow-up, and CRC treatment for underserved populations. This commentary represents the consensus of a diverse group of experts in cancer control and prevention, epidemiology, gastroenterology, and primary care from across the country who formed the Coalition to Boost Screening among the Underserved in the United States. The group was organized and held its first annual working group meeting in conjunction with the World Endoscopy Organization's annual Colorectal Cancer Screening Committee meeting during Digestive Disease Week 2012 in San Diego, California. © The Author 2014. Published by Oxford University Press. All rights reserved.

Author Keywords

[No Keywords available]

Index Keywords

Medically Underserved Area medically uninsured health care planning mass screening methodology Randomized Controlled Trials as Topic randomized controlled trial (topic) minority group human middle aged statistics colorectal tumor Aged Colorectal Neoplasms sigmoidoscopy occult blood Early Detection of Cancer United States Humans migrant consensus colonoscopy male Emigrants and Immigrants female Minority Groups Review Incidence adult health care quality Quality of Health Care medicaid Healthcare Disparities health care disparity mortality early diagnosis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84898864070&doi=10.1093%2fjnci%2fdju032&partnerID=40&md5=2b12aaf80891d38a0ede03f6723afdf0
DOI: 10.1093/jnci/dju032
ISSN: 00278874
Cited by: 99
Original Language: English