Primary Care Research

Rates of colorectal cancer screening increased modestly from 2000 to 2003, but still remain low

Colorectal cancer (CRC) is a common cancer among both men and women in the United States. Despite recommendations for people to begin CRC screening at age 50, only about half of this age group has been screened for CRC, according to a new study. A growing number of States now mandate that private insurers cover CRC screenings, and Medicare began coverage for CRC screening in 2000. Despite these shifts in policy, rates of CRC screening increased only modestly from 2000 to 2003 and still remain low. Based on data from the 2000 and 2003 National Health Interview Surveys of U.S. households, 55 percent of adults 50 years and older had been screened for CRC in 2003 compared with 53 percent in 2000.

However, most people who were screened at all were up-to-date with screening. Among adults who ever underwent CRC screening, 76 percent were up-to-date with screening in 2003 compared with 68 percent in 2000. In both time periods, individuals more likely to be up-to-date with screening were those with higher income, more education, insurance coverage, a usual source of care, and a dental visit in the last year.

From 2000 to 2003, there was increased use of colonoscopies, but decreased use of fecal occult blood tests and sigmoidoscopies. A fecal occult blood test is recommended each year, a sigmoidoscopy every 5 years, and a colonoscopy every 10 years. The researchers call for more studies to uncover barriers to CRC screening and to develop strategies to overcome them. Their study was supported in part by the Agency for Healthcare Research and Quality (HS10771 and HS10856).

See "Rates and predictors of colorectal cancer screening," by Su-Ying Liang, Ph.D., Kathryn A. Phillips, Ph.D., Mika Nagamine, Ph.D., and others, in the October 2006 Preventing Chronic Disease, which is available at http://www.cdc.gov/pcd/issues/2006/oct/06_0010.htm.

Editor's Note: Another AHRQ-supported article by the same group of researchers concluded that few studies of cancer screening preferences exist. The available studies examine only a few types of cancer and do not explore practice and policy implications in depth. For more details, see "A review of studies examining stated preferences for cancer screening," by Phillips, K.A., Van Bebber, S., Marshall, D., and others, in the July 2006 Preventing Chronic Disease, which is available at http://www.cdc.gov/pcd/issues/2006/jul/05_0208.htm.

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