Racial disparities in the rates of screening for colorectal cancer have improved in several states since the implementation of the Medicare Modernization Act of 2003, according to a recent study led by a researcher at the School of Public Health at Georgia State University, but many states have not seen significant improvement.
For the vast majority of states, “disparities persisted with Whites and Males exhibiting greater rates of utilization than other groups,” the authors wrote.
“While some gains were made over this time period, the gains were unevenly distributed across the USA and more work needs to be done to reduce remaining disparities.”
The law, enacted in 2006, expanded managed care options for seniors, covering more prescription drugs for those on Medicare, whether they were in managed care plans or fee-for-service plans. That, in turn, freed up funds that those Medicare recipients could use to pay for colorectal screenings, the authors wrote.
The changes in coverage also came at a time when colonoscopies were becoming viewed as the gold standard for such screenings, and health promotions were conducted in some states to encourage increased screenings. The states that made special efforts to promote screening to minority groups during the study period generally saw a reduction in the disparity in screening rates.
Colorectal cancer is the third most common cancer in the U.S. The authors note that many cases of colorectal cancer can be prevented by the removal of pre-cancerous growths during the endoscopy test.
The study’s results are published in the Journal of Racial and Ethnic Health Disparities in an article titled, “What Happened to Disparities in CRC Screening Among FFS Medicare Enrollees Following Medicare Modernization? ” The study’s lead author is Dr. Lee Rivers Mobley, associate professor at the School of Public Health.
Researchers analyzed data for more than 17 million Medicare enrollees across the United States from periods spanning 2001-2005 (before the law went into effect) and 2006-2009 (after the law went into effect). The overall increase in colorectal screening during the study periods grew from 8 percent to 8.5 percent annually.
During the period studied, the gaps in screening rates for men and women also narrowed, the authors found, with women catching up to men.
The study’s authors also include Dr. Tzy-Mey Kuo of the University of North Carolina at Chapel Hill; Mei Zhou, M.S., M.A., of the Georgia Health Policy Center at Georgia State University; doctoral student Yamisha Rutherford and Seth Meador, MPH, of the School of Public Health at Georgia State; and Dr. Julia Koschinsky of the University of Chicago.