Colon cancer rates drop in older Americans, but disparities remain

Article published March 17, 2014

http://www.modernhealthcare.com/article/20140317/NEWS/303149911?AllowView=VDl3UXk1TzZDL09CbkJiYkY0M3hlMENvaTBVZEMrYz0=&utm_source=link-20140317-NEWS-303149911&utm_medium=email&utm_campaign=mpdaily&utm_name=top

 

By Sabriya Rice
“Dramatic” progress has been made in reducing colon cancer incidence and death rates in the U.S., but concerns remain about “striking” racial and socioeconomic disparities, according to new national statistics on colorectal cancer.

During the past decade, colon cancer incidence rates dropped by 30% in adults 50 and older, with the largest improvements seen in people older than age 65, the group most likely to die from the disease, found the report published Monday in CA: A Cancer Journal for Clinicians.

“We were very surprised to see that kind of drop in just one decade. That’s enormous,” said Rebecca Siegel, director of surveillance information for the American Cancer Society, and a co-author of the report.

Typically, declines in cancer rates average 1% to 2% annually, Siegel said, but in the case of colon cancer it was closer to 4%, which the report attributes to widespread increases in colonoscopy screening over the years.Between 2000 and 2010, the use of colorectal cancer screenings increased from 19% to 55% among adults ages 50 to 75, the analysis found. In 2010, 64% of people age 65 years and older reported having undergone a recent screening test. “Colorectal cancer is one of the few cancers that we can actually prevent with screening, so it’s a great opportunity,” Siegel said.

Despite the progress, researchers say there’s still more work to do.
“This is a really important and is a lifesaving test,” said Siegel, “but we still have more than a third of adults for whom screening is recommended (who are) not getting tested, and others who say they have never been screened.”

Screening rates remain low among the poor and uninsured, the report said, and there were substantial racial and ethnic differences in both incidence and death rates. For example, the death rate for blacks was 50% higher than that of whites, attributed to disproportionately higher poverty rates in the black community.

With more people gaining access to coverage as a result of the Patient Protection and Affordable Care Act, Siegel says she hopes some of the disparities will be addressed. But in general, she says, she is often shocked by how unaware the public remains on the role they can play in prevention.

“Colon cancer is one of the cancers we do know a lot about in terms of risk factors,” she said noting that any effort to encourage patients to achieve and maintain a healthy weight, increase physical activity, eat plant-based diets low in red and processed meats and quit smoking can help.

Colon cancer is currently the third leading cause of death for both men and women in the U.S. This year more than 136,000 individuals are projected to receive a colorectal cancer diagnosis, and more than 50,000 are projected to die from the disease.

The CA report used colon cancer incidence data drawn from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program and the North American Association of Central Cancer Registries, and mortality data from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

The CDC last November issued a report noting that comparative effectiveness data have shown at-home stool tests to be equivalent to colonoscopies at catching cancer early in patients who don’t have additional risk factors.

Follow Sabriya Rice on Twitter: @MHSRice

UPDATE 1-When Zach met Barack: pitching Obamacare online

Tue Mar 11, 2014 5:22pm EDT

(Adds White House comment, latest enrollment figures)

By Mark Felsenthal

Source Link:  http://www.reuters.com/article/2014/03/11/usa-obama-health-idUSL2N0M81YC20140311

(Reuters) – President Barack Obama took his quest to sign young people up for health insurance to an edgy comedy website on Tuesday, where he traded insults with host Zach Galifianakis while plugging his signature Obamacare health program.

Obama sat for an interview on “Between Two Ferns with Zach Galifianakis,” on the Funny or Die website. The actor, who starred in “The Hangover” films, is known for his cringe-inducing banter on the program.

Obama got the chance to urge the youth of America to get health insurance, but not until he’d been subjected to questions like “What is it like to be the last black president?” and “What should be done about North Ikea?”

The administration is stepping up efforts to increase youth participation in Obamacare, also known as the Affordable Care Act.

Youth participation is crucial to the success of the program, but U.S. government data released on Tuesday showed that while the number of people enrolled in private insurance under Obamacare reached 4.2 million, the proportion of adults aged 18-34 remained unchanged from January at 25 percent of total enrollment in private Obamacare plans.

That is well below the 38 percent that administration officials have talked about achieving to give insurers a strong mix of healthier members, whose premium payments help offset the cost of older, sicker policy holders.

Obama’s crusade to draw in young people has had help from singers Lady Gaga and John Legend, as well as sports celebrities including former basketball star Magic Johnson.

While Galifianakis, who once told an interviewer “rudeness is hilarious,” may have seemed an odd match for the president, the White House was thrilled at his ability to deliver a big audience of young people.

“Very quickly, this video went, you know, viral,” White House spokesman Jay Carney said. The segment had already been viewed 3 million times, he added.

The Funny or Die website was the top source of referrals Tuesday to healthcare.gov, the Obamacare website, Carney said.

On “Between Two Ferns,” Galifianakis did not dial back his trademark style, calling Obama a nerd and asking him if he was going to put his presidential library in his “home country” of Kenya.

The president appeared to play along gamely and tried to match Galifianakis insult for insult. “When I heard that people actually watch this show, I was pretty surprised,” Obama said.

When the president was finally allowed to make his pitch about the benefits of signing up for health insurance, Galifianakis sighed, looked at his watch and said, “Is this what they mean by drones?” (Reporting By Mark Felsenthal; Editing by Nick Zieminski and Tom Brown)

You Might Pay A Lot More Than $95 For Skipping Health Insurance

March 12, 2014 3:41 AM

2014 is the first year most Americans will have to either have health insurance or face a tax penalty.

But most people who are aware of the penalty think it’s pretty small, at least for this first year. And that could turn into an expensive mistake.

“I’d say the vast majority of people I’ve dealt with really believe that the penalty is only $95, if they know about it at all,” says Brian Haile, senior vice president for health policy at Jackson Hewitt Tax Service. “And when people find out, they’re stunned. It’s much, much higher than they would expect.”

In fact, “the penalty is the maximum of either $95 or 1 percent of taxable income in 2014,” according to Linda Blumberg, a senior fellow at the Urban Institute’s Health Policy Center. “For people with higher incomes it can be much more sizable than $95.”

Blumberg says that even for people with more moderate incomes, it’s important to remember that the flat fee penalty will be assessed for every family member who lacks health coverage.

“So if it’s a two-adult household and both are uninsured, it’s twice $95; $190,” he says. “Then if there are any children in the family that are uninsured, the penalty for each of them is half of the $95.”

The flat fee penalty maxes out at $285 next year. To help people figure out what they might owe, the Tax Policy Center, jointly run by the Urban Institute and the Brookings Institution, just posted an online calculator. And Jackson Hewitt has its own “How much is my tax penalty?” worksheet.

Haile says it’s important to remember that even if most of the family has insurance, having just one uninsured member can trigger the penalty.

“If you’ve got someone who comes home to live it could cost you much more than a spare bedroom,” he says. “If you claim that child as a dependent, or could claim that child as a dependent, then you suddenly become liable for penalties if that child lacks minimum essential coverage.”

The 1 percent penalty, for those hit with that, also has a cap, but the penalty can still get pretty big. The cap is tied to the cost of the national average bronze level insurance plan. This year’s top penalty could be about $3,600 for an individual, and $11,000 for a family of four.

If you’re uninsured and earn enough to be potentially liable for penalties, you have to sign up for coverage by the end of this month in order to avoid them.

“Your only chance to buy insurance, unless you have a special qualifying event, is during this open enrollment period,” Haile says, “which makes March 31 an incredibly important date for avoiding the penalty. If you want to avoid the penalty, you need to get in and sign up for coverage now.”

That’s much different than how things were before the law’s implementation. But the Urban Institute’s Linda Blumberg says it’s due to the new rule that protects people with pre-existing health conditions.

“Now the insurance companies can’t say no, even if you’ve had serious health problems in the past, or have a serious health problem today. They can’t deny you,” she says. “And because of that, people are restricted to obtaining coverage during the open enrollment period or during some other open enrollment period where they’ve had a change in their family status or income.”

Indeed, changes to family status — a birth, divorce, or job change — will allow you to buy orchange your coverage outside the open enrollment period. And if you’re eligible for Medicaid or your kids are eligible for the Children’s Health Insurance Program, you can sign up anytime.

There are also lots of exemptions from the penalty itself, Blumberg points out, even for people who remain uninsured. The biggest is having income below the tax filing threshold.

This year that’s roughly $10,000 for a single person and $13,000 for a head of household. If you don’t have to file income taxes, you won’t have to pay a penalty. You also can get an exemption if the cheapest available insurance would cost more than 8 percent of your income, if you have unpaid medical debt, or for any of several other reasons listed on the HealthCare.gov website.

But for most people with incomes above the poverty line, time is running out to either get insurance or prepare to pay up instead.