Vital signs: colorectal cancer screening among adults aged 50-75 years - United States, 2008

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer deaths in the United States and the leading cause of cancer deaths among nonsmokers. Statistical modeling indicates that, if current trends in health behaviors, screening, and treatment continue, U.S. residents can expect to see a 36% decrease in the CRC mortality rate by 2020, compared with 2000.

Methods: Every 2 years, CDC uses Behavioral Risk Factor Surveillance System data to estimate up-to-date CRC screening prevalence in the United States. Adults aged >or=50 years were considered to be up-to-date with CRC screening if they reported having a fecal occult blood test (FOBT) within the past year or lower endoscopy (i.e., sigmoidoscopy or colonoscopy) within the preceding 10 years. Prevalence was calculated for adults aged 50-75 years based on current U.S. Preventive Services Task Force recommendations.

Results: For 2008, the overall age-adjusted CRC screening prevalence for the United States was 62.9% among adult respondents aged 50--75 years, increased from 51.9% in 2002. Among the lowest screening prevalences were those reported by persons aged 50--59 years (53.9%), Hispanics (49.8%), persons with lower income (47.6%), those with less than a high school education (46.1%), and those without health insurance (35.6%).

Conclusions: CRC screening rates continue to increase in the United States. Underscreening persists for certain racial/ethnic groups, lower socioeconomic groups, and the uninsured.

Implications for public health practice: Health reform is anticipated to reduce financial barriers to CRC screening, but many factors influence CRC screening. The public health and medical communities should use methods, including client and provider reminders, to ensure test completion and receipt of follow-up care. Public health surveillance should be expanded and communication efforts enhanced to help the public understand the benefits of CRC screening.