Choice of Screening Modality in a Colorectal Cancer Education and Screening Program for the Uninsured

Abstract

Starting in 2001, the state of Maryland established a carefully planned and executed multicomponent intervention to reduce mortality and disparities in colorectal cancer. In the most populous county, uninsured participants received education and a choice of free screening by fecal occult blood testing (FOBT) or colonoscopy or both. Over 2 years, a group of 1,672 uninsured individuals, of whom 90% were minorities, registered with the program. Overall, screening uptake was 41% with colonoscopy, 10% with FOBT, and 10% with both FOBT and colonoscopy. The choices of colorectal cancer screening modalities by a diverse uninsured population demonstrates the importance of maintaining screening options.