Improved rates of colorectal cancer screening in an equal access population

BackgroundNational colorectal cancer (CRC) screening averages 50% to 60%. We aimed to identify screening prevalence in select Department of Defense (DOD) beneficiaries with equal access to care.MethodsDecember 2007 cross-sectional data of patients over 50 years of age included patient demographics, screening modality, and compliance.ResultsOf 17,252 patients (52% male; mean age 63.2 ± 8.1 years), 12,229 (71%) were up-to-date with national screening guidelines. Modalities included colonoscopy (83.0%), flexible sigmoidoscopy with fecal occult blood testing (FOBT) (32.2%), and air-contrast barium enema (0.7%). African American or Hispanic background (70% African American, 68% Hispanic vs 73% Caucasian), younger patients (66.1% <65 years vs 78.6% >65 years), and male gender (69.9% vs 72.1%; all P < .001) all had lower rates. Compared to 2005, more patients were current with guidelines (71% vs 64%) and colonoscopic screening (83% vs 71%).ConclusionsAlthough ethnicity-, gender-, and age-related disparities were observed, screening rates are improved in an equal access healthcare system.