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

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State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_5C943CDDA70B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association between colorectal cancer testing and insurance type: Evidence from the Swiss Health Interview Survey 2012.
Journal
Preventive medicine reports
Author(s)
Braun A.L., Kässner A., Syrogiannouli L., Selby K., Bulliard J.L., Martin Y., Guessous I., Tal K., Del Giovane C., Zwahlen M., Auer R.
ISSN
2211-3355 (Print)
ISSN-L
2211-3355
Publication state
Published
Issued date
09/2020
Peer-reviewed
Oui
Volume
19
Pages
101111
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
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 socio-demographic 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.
Keywords
Colonoscopy, Colorectal cancer screening, FOBT, Health insurance, Screening rates, Switzerland
Pubmed
Open Access
Yes
Create date
04/06/2020 8:36
Last modification date
18/06/2020 6:08
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