Vital signs: colorectal cancer screening test use--United States, 2012

Abstract

Background: Strong evidence exists that screening with fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy reduces the number of deaths from colorectal cancer (CRC). The percentage of the population up-to-date with recommended CRC screening increased from 54% in 2002 to 65% in 2010, primarily through increased use of colonoscopy.

Methods: Data from the 2012 Behavioral Risk Factor Surveillance System survey were analyzed to estimate percentages of adults aged 50-75 years who reported CRC screening participation consistent with United States Preventive Services Task Force recommendations.

Results: In 2012, 65.1% of U.S. adults were up-to-date with CRC screening, and 27.7% had never been screened. The proportion of respondents who had never been screened was greater among those without insurance (55.0%) and without a regular care provider (61.0%) than among those with health insurance (24.0%) and a regular care provider (23.5%). Colonoscopy was the most commonly used screening test (61.7%), followed by FOBT (10.4%). Colonoscopy was used by more than 53% of the population in every state. The percentages of blacks and whites up-to-date with CRC screening were equivalent. Compared with whites, a higher percentage of blacks across all income and education levels used FOBT.

Conclusions: Many age-eligible adults did not use any type of CRC screening test as recommended. Organized, population-based approaches might increase CRC screening among those who have never been screened. Promoting both FOBT and colonoscopy as viable screening test options might increase CRC screening rates and reduce health disparities.

FIGURE

Percentage of black and white respondents aged 50–75 years who reported colorectal cancer screening test use, by test type and selected characteristics — Behavioral Risk Factor Surveillance System (BRFSS), United States, 2012^* Abbreviations: FOBT = fecal occult blood test; GED = general equivalency diploma. ^* Data were weighted to the age, sex, and racial/ethnic distribution of each state’s adult population using intercensal estimates and were age-standardized to the 2012 BRFSS population. ^† FOBT within 1 year, or sigmoidoscopy within 5 years with FOBT within 3 years, or colonoscopy within 10 years. ^§ Annual household income.