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Indeed, researchers at the Fred Hutchinson Cancer Center last week reported racial disparities in colon cancer are widening, suggesting unequal improvements in screening access. In 1992, blacks were 60 percent more likely than white to be diagnosed with late-stage colorectal cancer; by 2004, that likelihood had doubled.
Medicare pays for colorectal screening -- with the exception of virtual colonoscopy -- but that government-run insurance program is for people 65 and older. So 22 states and four tribal organizations are about to begin free screening for low-income 50- to 64-year-olds, with CDC funding. Florida is offering both the stool test and colonoscopies; other states are choosing one or the other and will track public acceptance.
The NIH panel also pointed to Kaiser Permanente's ability to track down people due for screening and pull them in without waiting on them to show up in a doctor's office.
How? Combing electronic medical records of northern California patients, Kaiser learned in 2005 that only about 40 percent who needed a colon check had gotten one. The health maintenance organization already paid for colonoscopies and sigmoidoscopies, and still does for those who prefer them. But it tried mailing out stool kits in hopes of catching people wary of invasive testing -- with phone calls to those who didn't return them.
Last year, screening rates rose to 75 percent.
"It's kind of like doing your own science experiment at home," said Bob Cach, 56, of Livermore, Calif., recalling instructions for that first mailed test. He did fine.
But this year's kit signaled Cach had a problem. A follow-up colonoscopy removed a polyp, still benign. He's grateful it was caught, having watched his wife battle colon cancer over the past year.
"I am an advocate now for screening."
CDC-funded screening program: http://www.cdc.gov/cancer/crccp/
Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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