Gender disparities in colorectal cancer screening: True or false?

To date, nearly all studies examining gender disparities in colorectal cancer screening report a lower endoscopic screening rate in women. Using a statewide claims database, gender differences in screening rates were analyzed in an attempt to validate gender disparities reported in prior survey-based studies. Procedural-level dataset containing all patient encounters for 2003 in which a colonoscopy or flexible sigmoidoscopy were performed was created. Procedures were selected using CPT codes and univariate analysis was performed using SAS v 8.0. Statewide for average-risk individuals 50 years or older, 65,232 endoscopic procedures were performed in 2003. The majority (83%) of endoscopic screening procedures were colonoscopies. Overall, the rate of screening in average-risk women 50 years or older (38 procedures/1000 people) was slightly lower than in men (42/1000) but not statistically significant. The rates of screening were higher in women before the age of 60 years and lower after the age of 60 years. No clinically significant difference was found in the type of screening procedure performed. Gender dispar ities in rates and types of colorectal cancer screening reported in prior survey studies are not validated in this patient encounter data study.