Correlates of underutilization of colorectal cancer screening among U.S. adults, age 50 years and older

Prev Med. 2003 Jan;36(1):85-91. doi: 10.1006/pmed.2002.1127.


Background: Although effective screening for colorectal cancer (CRC) exists, only 37% of incident CRC are diagnosed at a localized stage at which treatment is effective. We identified demographic and other characteristics of adults (> or = 50 years old) who reported no CRC screening.

Methods: We calculated the prevalence of never having had a fecal occult blood test and/or a sigmoidoscopy or colonoscopy by age, sex, and other factors using the 1999 Behavioral Risk Factor Surveillance System data.

Results: CRC screening tests were underutilized across all segments of the population. Underutilization was highest in persons aged 50-64 years and those with lower education and a lack of health insurance and preventive services.

Conclusions: The data indicate that large proportions of average-risk adults across various sociodemographics and behavioral factors are not utilizing recommended CRC screening tests. There is a need to increase the awareness of the importance of utilizing effective CRC screening tests for the early detection of colorectal cancers.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colonoscopy / statistics & numerical data*
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / prevention & control*
  • Data Collection
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Middle Aged
  • Occult Blood*
  • Patient Acceptance of Health Care
  • Risk Factors
  • Socioeconomic Factors
  • United States