CDC: Colorectal Screening Rates Remain Low

Despite recommendations by the US Preventive Services Task Force for adults ages 50 to 75 to be tested for colorectal cancer, about one in three adults in that age range have not had the screening test, according to a new report.

“There are more than 20 million adults in this country who haven’t had any recommended screening for colorectal cancer and who may therefore get cancer and die from a preventable tragedy,” said CDC Director Tom Frieden, M.D., M.P.H. “Screening for colorectal cancer is effective and can save your life.”

According to the Centers for Disease Control and Prevention, colorectal cancer is the second leading cancer killer among men and women in the US, after lung cancer. The screening test is important, according to the CDC, because it can prevent cancer or detect it at an early stage, when treatment can be highly effective. Adults aged 50 and older should get tested with one or a combination of these screening tests:

• Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) done at home every year,
• Flexible sigmoidoscopy, done every five years, with FOBT/FIT done every three years,
• Colonoscopy done every 10 years.

The tests differ from each other. A colonoscopy can detect cancer early, and it can find precancerous polyps so they can be removed before they turn into cancer. An FOBT/FIT is a simple at-home test that can detect cancer early by identifying blood in the stool, a possible sign of cancer.

According to the CDC, people are not always offered a choice of colorectal cancer tests, but studies have shown that people who are able to choose the test they prefer are more likely to get the test done.

In the new report, researchers reviewed colorectal cancer screening data from CDC’s 2012 Behavioral Risk Factor Surveillance System to estimate the percentage of people aged 50 to 75 years who reported getting screened for colorectal cancer. Their findings include:
• Among adults who were screened as recommended, colonoscopy was by far the most common screening test (62 percent). Use of the other USPSTF-recommended tests was much lower: fecal occult blood test (10 percent), and flexible sigmoidoscopy in combination with FOBT/FIT (less than 1 percent).
• The highest percentage of adults who were up-to-date with colorectal cancer screening was in Massachusetts (76 percent).
• The percentage of people screened for colorectal cancer using the fecal occult blood test within one year was more than twice as high in California (20 percent) when compared with most states. Blacks and whites had similar screening rates, but a higher percentage of blacks across all income and education levels used FOBT.

The researchers say more people may get tested if health care providers contact them at their home or in a community setting; advise them of each test; and monitor patients to make sure they complete their test.

The report on colorectal cancer was the focus of CDC’s Vital Signs report for November 2013. Vital Signs is published each month and focuses on a leading health indicator.

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