Association between colorectal cancer testing and insurance type: Evidence from the Swiss Health Interview Survey 2012

被引:6
作者
Braun, Alexander Leonhard [1 ]
Kaessner, Anja [2 ]
Syrogiannouli, Lamprini [1 ]
Selby, Kevin [3 ]
Bulliard, Jean-Luc [3 ]
Martin, Yonas [1 ,4 ]
Guessous, Idris [5 ]
Tal, Kali [1 ]
Del Giovane, Cinzia [1 ]
Zwahlen, Marcel [2 ]
Auer, Reto [1 ,3 ]
机构
[1] Univ Bern, Inst Primary Hlth Care BIHAM, Mittelstr 43, CH-3012 Bern, Switzerland
[2] Univ Bern, Inst Social & Prevent Med ISPM, Bern, Switzerland
[3] Univ Lausanne, Ctr Primary Care & Publ Hlth Unisante, Lausanne, Switzerland
[4] Univ Bern, Bern Univ Hosp, Inselspital, Dept Gen Internal Med, Bern, Switzerland
[5] Geneva Univ Hosp, Dept Community Med & Primary Care & Emergency Med, Unit Populat Epidemiol, Geneva, Switzerland
关键词
Colorectal cancer screening; Switzerland; FOBT; Colonoscopy; Screening rates; Health insurance; COLONOSCOPY; COUNTRIES;
D O I
10.1016/j.pmedr.2020.101111
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Both colonoscopy and fecal occult blood test (FOBT) are commonly used for colorectal cancer (CRC) screening, but colonoscopy costs much more than FOBT. Swiss insurance offers high or low deductibles and choice of basic or private insurance. We hypothesized that high deductibles and basic insurance discourage colonoscopy, but do not change FOBT rates. We determined the proportion of patients tested for CRC in Switzerland (colonoscopy within 10 years, FOBT within 2 years), and determined associations with health insurance type. We extracted data on 50-75-year-olds from the Swiss Health Interview Surveys of 2012 to determine colonoscopy and FOBT testing rates (n = 7335). Multivariate logistic regression models estimated prevalence ratios (PRs) of CRC testing associated with health insurance type (deductible and private insurance), adjusted for sociodemographic factors (age, gender, education, income) and self-rated health. The weighted proportion of individuals tested for CRC within recommended intervals was 39.5%. Testing with colonoscopy was significantly associated with private insurance (PR 1.85, 95% CI: 1.46-2.35) and low deductible (PR 2.00, 95% CI: 1.56-2.57). Testing with FOBT was significantly associated with deductible (PR 1.71, 95%CI:1.09-2.68) but not with private insurance. About 60% of the Swiss population was not current with CRC testing. After adjusting for covariates, private insurance and low deductible was significantly associated with higher prevalence of CRC testing, indicating that waiving the deductible could increase CRC screening uptake and reduce health inequality.
引用
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页数:6
相关论文
共 25 条
[1]  
[Anonymous], 2016, SCHWEIZERISCHER KREB
[2]   Screening for colorectal cancer [J].
Arditi, C. ;
Peytremann-Bridevaux, I. ;
Burnand, B. ;
Eckardt, V. F. ;
Bytzer, P. ;
Agreus, L. ;
Dubois, R. W. ;
Vader, J. -P. ;
Froehlich, F. ;
Pittet, V. ;
Filliettaz, S. Schussele ;
Juillerat, P. ;
Gonvers, J. -J. .
ENDOSCOPY, 2009, 41 (03) :200-208
[3]   INTERNATIONAL HEALTH CARE SYSTEMS Individual Responsibility and Community Solidarity - The Swiss Health Care System [J].
Biller-Andorno, Nikola ;
Zeltner, Thomas .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 373 (23) :2193-2197
[4]   Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies [J].
Brenner, Hermann ;
Stock, Christian ;
Hoffmeister, Michael .
BMJ-BRITISH MEDICAL JOURNAL, 2014, 348
[5]   Colonoscopy and sigmoidoscopy use among older adults in different countries: A systematic review [J].
Chen, Chen ;
Laecke, Eileen ;
Stock, Christian ;
Hoffmeister, Michael ;
Brenner, Hermann .
PREVENTIVE MEDICINE, 2017, 103 :33-42
[6]   Colorectal Cancer Screening in Switzerland: Cross-Sectional Trends (2007-2012) in Socioeconomic Disparities [J].
Fedewa, Stacey A. ;
Cullati, Stephane ;
Bouchardy, Christine ;
Welle, Ida ;
Burton-Jeangros, Claudine ;
Manor, Orly ;
Courvoisier, Delphine S. ;
Guessous, Idris .
PLOS ONE, 2015, 10 (07)
[7]   Obesity and overweight associated with lower rates of colorectal cancer screening in Switzerland [J].
Fischer, Roland ;
Collet, Tinh-Hai ;
Zeller, Andreas ;
Zimmerli, Lukas ;
Gaspoz, Jean-Michel ;
Giraudon, Karine ;
Rodondi, Nicolas ;
Cornuz, Jacques .
EUROPEAN JOURNAL OF CANCER PREVENTION, 2013, 22 (05) :425-430
[8]   Healthcare Demand in the Presence of Discrete Price Changes [J].
Gerfin, Michael ;
Kaiser, Boris ;
Schmid, Christian .
HEALTH ECONOMICS, 2015, 24 (09) :1164-1177
[9]   Colorectal Cancer Screening and State Health Insurance Mandates [J].
Hamman, Mary K. ;
Kapinos, Kandice A. .
HEALTH ECONOMICS, 2016, 25 (02) :178-191
[10]   The importance of health insurance as a determinant of cancer screening: Evidence from the Women's Health Initiative [J].
Hsia, J ;
Kemper, E ;
Kiefe, C ;
Zapka, J ;
Sofaer, S ;
Pettinger, M ;
Bowen, D ;
Limacher, M ;
Lillington, L ;
Mason, E .
PREVENTIVE MEDICINE, 2000, 31 (03) :261-270