Disparities in screening still persist in certain populations

The percentage of U.S. adults aged 50 years and older getting screened for colorectal cancer is increasing according to a study released by the Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report. The study uses state-level Behavioral Risk Factor Surveillance Survey (BRFSS) data that have been combined to estimate that 60.8 percent of adults were current with colorectal cancer screening recommendations in 2006, compared with 53.9 percent in 2002.

"While we are encouraged to see an increase in colorectal cancer screening rates, certain groups are still not getting screened as recommended," said Djenaba A. Joseph, M.D., the report’s lead author and medical officer, Division of Cancer Prevention and Control. "We need to ensure that all adults have access to these life-saving tests because there is strong scientific evidence that screening can prevent colorectal cancer deaths."

Screening prevalence was lower among all racial and ethnic minorities studied compared to whites. The study also reports that screening rates continue to be lower among those without health insurance, with low income, and with less than a high school education.

Colorectal cancer is the nation’s second leading cause of cancer deaths. In 2004, almost 145,000 people in the United States were diagnosed with colon cancer and more than 53,000 died from the disease.

Regular screening is recommended for men and women beginning at age 50, using one or a combination of these screening tests:

• Home Fecal occult blood test (FOBT) – a test that checks for hidden blood in the stool.
• Colonoscopy - an examination of the rectum and entire colon using a colonscope (a lighted instrument).
• Flexible sigmoidoscopy - an examination of the rectum and lower colon using a sigmoidoscope (a lighted instrument).
• Double contrast barium enema – a series of x-rays of the entire colon and rectum.

Screening tests for colorectal cancer can find precancerous polyps (abnormal growths) in the colon and rectum before they turn into cancer. Screening also helps find this cancer at an early stage when treatment can be most effective.

To estimate the current rates of colorectal cancer screening and to measure changes in use of screening, CDC scientists compared data from the 2002, 2004, and 2006 BRFSS telephone surveys. For this report, sigmoidoscopy and/or colonoscopy are described as lower endoscopy. Significant findings from this study show:

• The percentage of adults aged 50 years and older who reported having had a home FOBT within one year and/or lower endoscopy within 10 years before the survey increased from 54 percent in 2002, 57 percent in 2004, and to 60 percent in 2006.
• The percentage of adults who reported having had a home FOBT within one year before the survey declined from 22 percent in 2002, 19 percent to 2004, and to 16 percent in 2006.
• The percentage of adults who reported having had lower endoscopy within 10 years before the survey increased from 45 percent in 2002, to 50 percent in 2004, and to 56 percent in 2006.
• The percentage of adults who reported never being screened for colorectal cancer decreased from 34 percent in 2004, 32 percent in 2004, and to 30 percent in 2006.
• In 2006, the percentage of adults who reported having had a home FOBT and/or lower endoscopy within 10 years before the survey ranged from 52 percent in Mississippi to 71 percent in Connecticut.

To address the disparities in screening, in 2005, CDC established colorectal cancer screening demonstration programs at five sites in the United States for persons with low income and inadequate or no colorectal cancer screening insurance coverage. Additional information about these programs is available at http://www.cdc.gov/cancer/colorectal/what_cdc_is_doing/demonstration/.

CDC's Screen for Life: National Colorectal Cancer Action Campaign is aimed at informing men and women aged 50 years or older about the importance of having regular colorectal cancer screening tests. Information about Screen for Life can be found at http://www.cdc.gov/cancer/colorectal/sfl/.

Speak with your doctor or health care professional about getting screened for colorectal cancer, using one or more of the recommended screening tests.

Contact:
CDC, National Center for Chronic
Disease Prevention and Health Promotion
Office of Communication, 770-488-5131