No colorectal cancer decline in U.S. poor

ATLANTA, June 26 (UPI) -- A drop in colorectal cancer incidence seen throughout the United States has not occurred among people living in poorer communities, researchers said.

American Cancer Society epidemiologists examined colorectal cancer incidence trends from 1995-2004 from 19 cancer registries covering about 53 percent of the U.S. population. They compared incidence rates among different ages, races/ethnicities and county-level indicators of access to healthcare -- poverty level, supply of primary care physicians, insurance rates, and metro vs. non-metro area.

The study, published in the journal Cancer Causes and Control, found colorectal cancer incidence rates decreased significantly across all categories of counties among whites age 65 and older, who are almost all covered by Medicare, but not among those ages 50-64 in counties with high uninsured or poverty rates, fewer primary care physicians, or in non-metro areas.

The authors say the study suggests the decrease in incidence rates among whites 65 and older across all categories of counties may in part reflect an increase in endoscopic screening rates after Medicare expanded reimbursement of selected screening tools in 1998 and 2001.

In contrast, the lack of decrease in colorectal cancer incidence rates among some population subgroups -- including those 50-64 year old Hispanics and African-Americans in general and whites residing in the most disadvantaged areas -- may reflect lack of access to primary care as well as endoscopic screening services.