Disparities in the Uptake of Colorectal Cancer Screenings: The Role of Education, Insurance, and Screening Type

Abstract

Preventative screenings hold the promise of detecting disease before it becomes fatal. However, they often have the unintended consequence of creating socioeconomic disparities because individuals with social and economic resources are the heaviest users. This research investigates education- and insurance-based disparities in colorectal cancer screening participation and how these associations change over time. I use data from the National Health Interview Survey (NHIS) to analyze trends in colorectal cancer screening participation for adults over 50 from 1992 to 2013 (n=51,385). Controlling for key sociodemographic factors, results suggest that education and access to insurance have become increasingly important predictors of screening participation over time. Specifically, the findings appear to primarily apply to endoscopy use, a more invasive and expensive type of colorectal cancer screening. By showing that education and insurance are more relevant for predicting endoscopy use, this study contributes to fundamental cause research on the uptake of medical innovations; the study shows that the use of complicated technologies is more heavily influenced by socioeconomic factors. I conclude by considering how policy changes can reduce socioeconomic disparities in cancer screenings.