Relationships Between Health Care Disparities and Coverage Policies for Breast, Colon, and Lung Cancer Screening

Lincoln L. Berland, Debra L. Monticciolo, Efren J. Flores, Sharp F. Malak, Judy Yee, Debra S. Dyer

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Disparities in outcomes exist for breast, colon, and lung cancer among diverse populations, particularly racial and ethnic underrepresented minorities (URMs) and individuals from lower socioeconomic status. For example, blacks experience mortality rates up to about 42% higher than whites for these cancers. Furthermore, although overall death rates have been declining, the differential access to screening and care has aggravated disparities. Our purpose is to assess how the coverage policies of CMS and the United States Preventive Services Task Force (USPSTF) influence these disparities. Additionally, barriers are often encountered in accessing screening tests and receiving prompt treatment. To narrow, and potentially eliminate, outcomes disparities, CMS and USPSTF could consider revising their decision-making processes regarding coverage. Some options include (1) extending their evidence base to include observational studies that involve groups at higher risk; (2) lowering the threshold ages for screening to encompass differences in incidence; (3) CMS approving screening CT colonography coverage, which can even increase compliance with other screening tests; (4) clarifying and streamlining guidelines; (5) supporting research on improving access to screening; and (6) encouraging the development of more navigation services for URMs.

Original languageEnglish (US)
Pages (from-to)580-585
Number of pages6
JournalJournal of the American College of Radiology
Issue number4
StatePublished - Apr 2019


  • CT colonography
  • Screening
  • health care disparities
  • lung cancer screening
  • mammography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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