TY - JOUR
T1 - Relationships Between Health Care Disparities and Coverage Policies for Breast, Colon, and Lung Cancer Screening
AU - Berland, Lincoln L.
AU - Monticciolo, Debra L.
AU - Flores, Efren J.
AU - Malak, Sharp F.
AU - Yee, Judy
AU - Dyer, Debra S.
N1 - Publisher Copyright:
© 2019 American College of Radiology
PY - 2019/4
Y1 - 2019/4
N2 - Disparities in outcomes exist for breast, colon, and lung cancer among diverse populations, particularly racial and ethnic underrepresented minorities (URMs) and individuals from lower socioeconomic status. For example, blacks experience mortality rates up to about 42% higher than whites for these cancers. Furthermore, although overall death rates have been declining, the differential access to screening and care has aggravated disparities. Our purpose is to assess how the coverage policies of CMS and the United States Preventive Services Task Force (USPSTF) influence these disparities. Additionally, barriers are often encountered in accessing screening tests and receiving prompt treatment. To narrow, and potentially eliminate, outcomes disparities, CMS and USPSTF could consider revising their decision-making processes regarding coverage. Some options include (1) extending their evidence base to include observational studies that involve groups at higher risk; (2) lowering the threshold ages for screening to encompass differences in incidence; (3) CMS approving screening CT colonography coverage, which can even increase compliance with other screening tests; (4) clarifying and streamlining guidelines; (5) supporting research on improving access to screening; and (6) encouraging the development of more navigation services for URMs.
AB - Disparities in outcomes exist for breast, colon, and lung cancer among diverse populations, particularly racial and ethnic underrepresented minorities (URMs) and individuals from lower socioeconomic status. For example, blacks experience mortality rates up to about 42% higher than whites for these cancers. Furthermore, although overall death rates have been declining, the differential access to screening and care has aggravated disparities. Our purpose is to assess how the coverage policies of CMS and the United States Preventive Services Task Force (USPSTF) influence these disparities. Additionally, barriers are often encountered in accessing screening tests and receiving prompt treatment. To narrow, and potentially eliminate, outcomes disparities, CMS and USPSTF could consider revising their decision-making processes regarding coverage. Some options include (1) extending their evidence base to include observational studies that involve groups at higher risk; (2) lowering the threshold ages for screening to encompass differences in incidence; (3) CMS approving screening CT colonography coverage, which can even increase compliance with other screening tests; (4) clarifying and streamlining guidelines; (5) supporting research on improving access to screening; and (6) encouraging the development of more navigation services for URMs.
KW - CT colonography
KW - Screening
KW - health care disparities
KW - lung cancer screening
KW - mammography
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U2 - 10.1016/j.jacr.2018.12.025
DO - 10.1016/j.jacr.2018.12.025
M3 - Article
C2 - 30947890
AN - SCOPUS:85062229218
SN - 1546-1440
VL - 16
SP - 580
EP - 585
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 4
ER -