Racial/ethnic and socioeconomic disparities in colorectal cancer screening in a large organization with universal insurance before and during the coronavirus disease 2019 pandemic-Reference-Cited by-同舟云学术

Racial/ethnic and socioeconomic disparities in colorectal cancer screening in a large organization with universal insurance before and during the coronavirus disease 2019 pandemic

Published:2023-11-14 Issue: Volume: Page:
ISSN:0969-1413
Container-title:Journal of Medical Screening
language:en
Short-container-title:J Med Screen

Author:

Levi Zohar¹²^ORCID,Abu-Frecha Naim³⁴^ORCID,Comanesther Doron⁵,Backenstein Tania⁵,Cohen Arnon D⁴⁵,Eizenstein Sapir²,Flugelman Anath⁶,Weinstein Orly⁷

Affiliation:

1. Division of Gastroenterology, Rabin Medical Center, Clalit Health Services, Israel

2. Tel Aviv University, Israel

3. Department of Gastroenterology, Soroka Medical Center, Clalit Health Services, Israel

4. Ben-Gurion University, Beer Sheva, Israel

5. Division of Health Policy, Department of Quality Measures, Clalit Health Services, Israel

6. Technion Israel Institute of Technology The Ruth and Bruce Rappaport Faculty of Medicine Haifa, Haifa, IL, USA

7. The Clalit Health Services Headquarters, Tel Aviv, Israel

Abstract

Objectives Israel is regarded as a country with a developed economy and a moderate income inequality index. In this population-based study, we aimed to measure the inequalities in colorectal cancer screening within Clalit Health, an organization with universal insurance, before and during the coronavirus disease 2019 pandemic. Setting Retrospective analysis within Clalit Health Services, Israel. Methods We evaluated the rate of being up to date with screening (having a colonoscopy within 10 years or a fecal occult blood test within 1 year) and the colonoscopy completion rate (having a colonoscopy within 6 months of a positive fecal occult blood test) among subjects aged 50–75 in 2019–2021. Results In 2019, out of 918,135 subjects, 61.3% were up to date with screening; high socioeconomic status: 65.9% (referent), medium-socioeconomic status: 60.1% (odds ratio 0.81, 95% confidence interval 0.80–0.82), low-socioeconomic status: 59.0% (odds ratio 0.75, 95% confidence interval 0.74–0.75); Jews: 61.9% (referent), Arabs: 59.7% (odds ratio 0.91, 95% confidence interval 0.90–0.92), Ultraorthodox-Jews: 51.7% (odds ratio 0.77, 95% confidence interval 0.75–0.78). Out of 21,308 with a positive fecal occult blood test, the colonoscopy completion rate was 51.8%; high-socioeconomic status: 59.8% (referent), medium-socioeconomic status: 54.1% (odds ratio 0.79, 95% confidence interval 0.73–0.86), low-socioeconomic status: 45.5% (odds ratio 0.60, 95% confidence interval 0.56–0.65); Jews: 54.7% (referent), Ultraorthodox-Jews: 51.4% (odds ratio 0.91, 95% confidence interval 0.90–0.92), Arabs: 44.7% (odds ratio 0.77, 95% confidence interval 0.75–0.78). In 2020–2021, there was a slight drop in the rate of being up to date with screening, while most of the discrepancies were kept or slightly increased with time. Conclusions We report significant inequalities in colorectal cancer screening before and during the coronavirus disease 2019 pandemic in Israel, despite a declared policy of equality and universal insurance.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

Link

http://journals.sagepub.com/doi/pdf/10.1177/09691413231214186

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