California ahead on colon cancer screening

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California has made significant progress in getting the word out about the importance of colorectal cancer screening, the results of the 2001 California Health Interview Survey suggest.

Among some 22,000 ethnically diverse California residents 50 years of age or older, nearly 54 percent reported having a colorectal test in 2001.

This figure “appears to be ahead of national rates, which were 41 percent for men and 38 percent for women in 2000,” Dr. David A. Etzioni from the UCLA School of Medicine and associates note in the journal Cancer.

"California should be applauded for its achievements and encouraged to continue its efforts,” they add.

Despite the “relatively widespread” use of colorectal testing in California, women remain less likely than men to undergo colorectal screening, according to the survey.

It may be that women and their health care providers “perceive colorectal as less important compared with men and their providers,” the authors suggest. Study co-author Dr. Ninez A. Ponce told Reuters Health that one of the biggest surprises was that “women were more likely than men to report that their physicians told them it wasn’t needed.”

The lower rate of colorectal screening among Latinos compared with whites is a “second area of concern,” the team writes. Latino women younger than age 65 have especially low rates of colorectal test use.

“A number of Latinos and Asians who never had the test said that they were healthy and didn’t need it,” Dr. Ponce noted. “Doctors need to make more of an effort to recommend colorectal tests to women and Latinas.”

People with health insurance and a usual source of healthcare were more likely to have a colorectal test. This “continues to underscore that if everyone had health insurance and continuity of care, then colorectal test use would be much higher,” Ponce said.

“The last decade has seen a remarkable increase both in the amount of evidence supporting the efficacy of colorectal testing and in the acceptance of these examinations,” the authors note in their report.

“The ongoing challenge remains to provide effective early detection programs to the greatest proportion of the population.”

SOURCE: Cancer, December 1, published online October 25, 2004.

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