Underuse of screening sigmoidoscopy and colonoscopy in a large cohort of US adults

Am J Public Health. 2004 Oct;94(10):1775-81. doi: 10.2105/ajph.94.10.1775.


Objectives: We examined the prevalence of endoscopy (sigmoidoscopy or colonoscopy) by indication and by demographic and lifestyle factors.

Methods: We analyzed cross-sectional data collected in 1997 from participants aged 50 years and older in the Cancer Prevention Study (CPS) II Nutrition Cohort.

Results: Fifty-eight percent of men and 51% of women reported ever having undergone endoscopy; only 42% of men and 31% of women reported endoscopy for screening rather than for disease diagnosis or follow-up. Prevalence varied by demographic and lifestyle factors.

Conclusions: Efforts to increase colorectal cancer screening need to target women, all persons aged 50-64 years, and those with colorectal cancer risk factors. Future studies should distinguish endoscopy for screening from procedures for disease diagnosis and follow-up to avoid overestimating screening compliance.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Colonoscopy / statistics & numerical data*
  • Colorectal Neoplasms / prevention & control*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Life Style
  • Likelihood Functions
  • Male
  • Middle Aged
  • Risk Factors
  • Sigmoidoscopy / statistics & numerical data*
  • United States