Colorectal cancer screening use among insured adults: Is out-of-pocket cost a barrier to routine screening?

Table 1 Characteristics of 2012 Behavioral Risk Factor Surveillance System respondents ages 50-75 years old who had health insurance by the affordability of doctor visit n (%)

Variables	Cost precluded a doctor visit1	Cost did not affect a doctor visit	P-value	Odds ratio (99%CI)
Total (n = 215436)	16517 (9)	198919 (91)
Age group (n)
50-64 (127569)	12149 (73.6)	115420 (58.0)	< 0.0001
65-75 (87867)	4368 (26.4)	83499 (42.0)		2.01 (1.92, 2.11)
Gender (n)
Male (86028)	5442 (32.9)	80586 (40.5)	< 0.0001
Female (129408)	11075 (67.1)	118333 (59.5)		0.72 (0.69-0.75)
Race/ethnicity (n)
White, non-Hispanic (177916)	11806 (71.5)	166110 (83.5)	< 0.0001
Black, non-Hispanic (16861)	2107 (12.8)	14754 (7.4)		0.50 (0.47-0.53)
Hispanic (7847)	1049 (6.4)	6798 (3.4)		0.46 (0.41-0.51)
Others (10314)	1321 (8.0)	8993 (4.5)		0.48 (0.43-0.54)
Education attainment (n)
Did not Graduate High School (15280)	2367 (14.3)	12,913 (6.5)	< 0.0001
Graduated High School (62826)	5439 (32.9)	57387 (28.8)		0.75 (0.70-0.80)
Attended College/Technical School (58305)	4852 (29.4)	53453 (26.9)		0.78 (0.74-0.83)
Graduated College/Technical School (78388)	3795 (23.0)	74593 (37.5)		1.40 (1.32-1.48)
Health status (n)
Excellent/very good/good (169114)	8841 (53.5)	160273 (80.6)	< 0.0001
Fair/poor (45648)	7594 (46.0)	38054 (19.1)		0.28 (0.26-0.29)
Body mass index (kg/m2)
Normal (2666)	280 (1.7)	2386 (1.2)	0.0205
Overweight (60265)	4099 (24.8)	56166 (28.2)		0.97 (0.82-1.15)
Obese (77582)	5177 (31.3)	72405 (36.4)		0.99 (0.94-1.05)
Current smokers (n)
Yes (31599)	4119 (24.9)	27480 (13.8)	< 0.0001	2.09 (1.99-2.20)
No (179993)	12034 (72.9)	167959 (84.4)
Binge drinkers2 (n)
Yes (18355)	1349 (8.2)	17006 (8.5)	0.9101
No (189647)	14486 (87.7)	175161 (88.1)		0.96 (0.89-2.20)
Have a personal doctor or health care, provider
Yes, at least one (200482)	14657 (88.7)	185825 (93.4)	< 0.0001
No (14554)	1801 (10.9)	12753 (6.4)		0.56 (0.52-0.60)

Missing not included; therefore, some variables’ total percentages do not meet 100%.

¹Adults who could not see a doctor in the last 12 mo because of cost;

²Males having five or more drinks on one occasion, females having four or more drinks on one occasion.

Table 2 Colorectal cancer screening of the 20122 Behavioral Risk Factor Surveillance System respondents ages 50-75 years old n (%)

Variables	Cost precluded a doctor visit	Cost did not preclude a doctor visit	P-value	Odds ratio (99%CI)
Time since last blood stool test (n)
Within the past year (20496)	1420 (9.1)	19076 (10.0)	< 0.0001
Within the past 2 to < 5 yr (29863)	1838 (11.8)	28025 (14.9)		1.25 (1.14-1.38)
5 or more years (25290)	1569 (10.1)	23721 (12.6)		1.24 (1.13-1.36)
Never (128556)	10717 (68.9)	117839 (62.5)		0.90 (0.84-0.97)
Time since last sigmoidoscopy (n)
Within the past year (1053)	80 (0.5)	973 (0.5)	< 0.0001
Within the past 2 to < 5 yr (2645)	172 (1.0)	2473 (1.2)		1.18 (0.82-1.70)
5 or more years (2888)	238 (1.4)	2650 (1.3)		1.24 (1.13-1.36)
Never (57443)	5913 (35.8)	51530 (25.9)		0.90 (0.84-0.97)
Time since last colonoscopy (n)
Within the past year (33454)	2316 (14.0)	31138 (15.7)	< 0.0001
Within past 2 to < 5 yr (77619)	4634 (28.1)	72985 (36.7)		1.29 (1.21-1.39)
5 or more years (28253)	1931 (11.7)	26322 (13.2)		1.12 (1.04-1.20)
Never (57443)	5913 (35.8)	51530 (25.9)		0.72 (0.67-0.77)

Missing values not included; therefore, some variables’ total percentages do not meet 100%.