Cancer Prevention & Control, Client-Oriented Screening Interventions: Reducing Out-of-Pocket Costs
Some interventions seek to increase cancer screening by reducing out-of-pocket costs. They may do so by reducing the costs of the screening tests, providing vouchers, reimbursing clients or clinics, and/or reducing health insurance costs.
Task Force Recommendations & Findings
The Task Force on Community Preventive Services recommends interventions that reduce out-of-pocket costs to clients to increase screening for breast cancer based on sufficient evidence of effectiveness.
The Task Force concluded there was insufficient evidence to determine the effectiveness of reducing out-of-pocket costs to increase:
- Cervical cancer screening by Pap test (based on a small number of studies)
- Colorectal cancer screening by fecal occult blood testing (FOBT), flexible sigmoidoscopy, colonoscopy, or double contrast barium enema (no studies qualified for review)
Results from the Systematic Reviews
Breast Cancer
Eight studies qualified for the systematic review.
- Studies evaluated the extension of Medicare or state benefits to cover periodic mammography and two assessed the use of free client vouchers (6 studies).
- Proportion of study participants completing mammography: median increase of 11.5 percentage points (8 studies).
Findings should be applicable to various populations and settings in which people would accept screening but have limited financial resources.
Find a Research-tested Intervention Program (RTIP) about reducing out-of-pocket costs to increase breast cancer screening (What is an RTIP?).
Cervical Cancer
The evidence was insufficient to determine effectiveness because only one study of adequate quality was found. The study reported a 17 percentage point increase in Pap test completion.
Colorectal Cancer
No studies qualified for the review.
No studies meeting Community Guide inclusion standards were found reporting on economic outcomes related to breast, cervical, or colorectal cancer screening.
These findings were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to cancer prevention and control.
Supporting Materials
Publications
Baron RC, Rimer BK, Coates RJ, et al. Client-directed interventions to increase community access to breast, cervical, and colorectal cancer screening: a systematic review. Am J Prev Med 2008;35(1S): S56-66.
Task Force on Community Preventive Services. Recommendations for client- and provider-directed interventions to increase breast, cervical, and colorectal cancer screening. Am J Prev Med 2008;35(1S): S21-5.
More Community Guide publications about Cancer Prevention and Control
Disclaimer
The findings and conclusions on this page are those of the Task Force on Community Preventive Services and do not necessarily represent those of CDC.
Sample Citation
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation:
Guide to Community Preventive Services. Cancer prevention & control, client-oriented screening interventions: reducing out-of-pocket costs. www.thecommunityguide.org/cancer/screening/client-oriented/ReducingOutOfPocketCosts.html. Last updated: MM/DD/YYYY.
Review completed: July 2008
- Page last reviewed: March 10, 2010
- Page last updated: August 24, 2010
- Content source: The Guide to Community Preventive Services
What are RTIPs and why consider them?
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