Wealthy Prefer Colonoscopy for Cancer Screening

Recent studies indicate that those above the poverty line prefer colonoscopy over the at-home stool testing as a form of screening colon cancer. The journal, Cancer, had an article that a change in the trend is emerging with people who can afford preferring colonoscopy.  However, those living under the poverty line still resort to the home stool testing as others did over a decade ago.

A professor at the University of Massachusetts Medical School, Dr. Chyke Doubeni, said that other types of colon cancer screening should be introduced to the lower socioeconomic group in order to encourage this group to go for this cancer screening. Options other than colonoscopy should be given to these patients according to Dr. Doubeni.

The government through the U.S. Preventive Services Task Force (USPSTF) is recommending that those people who have reached 50 years should have one and every ten years thereafter. They do not recommend a particular type of screening. The USPSTF also recommends sigmoidoscopy or fecal occult blood test every five years.  If fecal occult blood testing is used and the result is positive then a colonoscopy is needed to further diagnose if there are cancerous polyps in the bowel. The American Cancer Society says that there is a 1 to 20 chance of a person developing colon cancer.

The study made with Priti Brandi as lead author from the American Cancer Society explained that they intended to see if the preferences for the type of colon cancer screening changed over time.  They wanted the information available for public health officials and doctors so focus can be made on promoting screening for colon cancer.

Thousands of people from ages 50 to 64 took part to the National Health Survey conducted. The data was analyzed and determined that those who did at-home screening dropped 6%. They also found out that those with higher income levels and education changed their screening method. Those who were had low incomes or lower education levels remained the same over the time period.  It was clear from the study that colonoscopy or sigmoidoscopy was becoming more popular with the higher income or higher educated group.

The reason for the slower rate of preference by the lower income group maybe the cost of the screening test, Brandi said.  The lower income group may not have health benefits and if they do such expensive procedure like colonoscopy may not be covered. The procedure may cost $2,000 which is a lot higher than a fecal occult blood test which is about several hundred dollars.

Dr. Doubeni added that it is not really about the cost of the procedure. People should have the access to the screening test and the resources to have one when they need it. Doctors should be sensitive and should allow patients to have options when it comes to colon cancer screening. Recommending colonoscopy right away can deter people from getting the screening due to cost and other factors. He emphasized that patient preferences should be respected.

Another study supports Dr. Doubeni. It published those patients who were given choices to the type of screening agreed to proceed with the testing. Colon cancer screening percentages grew when options were given to options. Indeed, a recent study found that colon cancer screening rates shot up when patients got to choose which type of test they would have.

Dr. Joshua Fenton, professor at the University of California in Davis, said that doctors do not even think of fecal occult blood test as an option. This test should be considered for people who do not have resources for a colonoscopy.  Dr. Fenton is not a participant to any of the studies mentioned.