Patterns of Colorectal Cancer Test Use

The United States Preventive Services Task Force (USPSTF) recommends that men and women who are 50 to 75 years old should be screened for colorectal cancer in one of the following three ways—

• A high-sensitivity fecal occult blood test (FOBT) every year.
• Sigmoidoscopy every five years and a home FOBT every three years.
• A colonoscopy every 10 years.

A newer test that can be used for colorectal cancer screening is computed tomographic (CT) colonography, also called virtual colonoscopy. CT colonography is an X-ray test that uses CT scanning and computer software to make images of the colon and rectum, like a colonoscopy. Although the USPSTF doesn’t recommend CT colonography, other organizations recommend it every five years as a colorectal cancer screening option.

Screening Test Usage Rates

Using data from the National Health Interview Survey, the study found the following rates of colorectal cancer screening test use in 2010—

• 58.3% of Americans had been screened for colorectal cancer as recommended using any test.
• 54.6% had been screened for colorectal cancer with a colonoscopy within the previous 10 years.
• 8.8% had been screened with a home FOBT within the previous year.
• 1.3% had been screened with a sigmoidoscopy within the previous five years and a home FOBT within the previous three years.
• 1.3% had been screened with CT colonography.

Who Is More or Less Likely to Be Screened?

People were more likely to be screened for colorectal cancer if they—

• Had private or military health insurance.
• Had a high family income.
• Were college graduates.
• Were 60 to 75 years old.

People were less likely to be screened if they—

• Did not have health insurance.
• Did not have a usual source of health care.

About 40% of people in the United States who are 50 to 75 years old have not been screened for colorectal cancer as recommended. People who do not have health insurance or a usual source of health care were the least likely to be screened. Also, many people don’t know they need to be screened for colorectal cancer.

Citation

Shapiro JA, Klabunde CN, Thompson TD, Nadel MR, Seeff LC, White A. Patterns of colorectal cancer test use, including CT colonography, in the 2010 National Health Interview Survey. Cancer Epidemiology, Biomarkers and Prevention 2012;21(6):895–904.