About one in three adults aged 50 to 75 years have not been tested for colorectal cancer as recommended by the United States Preventive Services Task Force (USPSTF), according to a new Vital Signs report from the Centers for Disease Control and Prevention (CDC). Despite research that shows colorectal cancer screening tests save lives, screening rates remain too low. 

Colorectal Cancer

“There are more than 20 million adults in this country who haven’t had any recommended screening for colorectal cancer and who may therefore get cancer and die from a preventable tragedy,” said CDC Director Tom Frieden, MD, MPH. “Screening for colorectal cancer is effective and can save your life.”

Colorectal cancer is the second leading cancer killer among men and women in the United States, after lung cancer. Screening tests can prevent cancer or detect it at an early stage, when treatment can be highly effective. Adults aged 50 years and older should get tested with one or a combination of these screening tests:

• Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) done at home every year;

• Flexible sigmoidoscopy, done every five years, with FOBT/FIT done every three years;

• Colonoscopy done every 10 years.

A colonoscopy can detect cancer early, and it can find precancerous polyps so they can be removed before they turn into cancer. An FOBT/FIT is a simple at-home test that can detect cancer early by identifying blood in the stool, a possible sign of cancer. People are not always offered a choice of colorectal cancer tests, but studies have shown that people who are able to choose the test they prefer are more likely to get the test done.

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CDC researchers reviewed colorectal cancer screening data from CDC’s 2012 Behavioral Risk Factor Surveillance System to estimate the percentage of people aged 50 to 75 years who reported getting screened as recommended by type of test.

Major Findings

• Among adults who were screened as recommended, colonoscopy was by far the most common screening test (62%). Use of the other USPSTF-recommended tests was much lower: FOBT (10%), and flexible sigmoidoscopy in combination with FOBT/FIT (less than 1%).

• The highest percentage of adults who were up-to-date with colorectal cancer screening was in Massachusetts (76%).

• The percentage of people screened for colorectal cancer using the FOBT within one year was more than twice as high in California (20%) when compared with most states.

• Blacks and whites had similar screening rates, but a higher percentage of blacks across all income and education levels used FOBT.

The authors noted that increasing use of all tests may increase screening rates.  Furthermore, research shows that more people may get tested if health care providers used an organized approach to identify people who need to be screened: contact them at their home or community setting; advise them of each test; and carefully monitor to make sure they complete their test.

CDC provides funding to 25 states and four tribal organizations across the United States to help increase colorectal cancer screening rates among men and women aged 50 years and older through organized screening methods. Through the Affordable Care Act, more Americans will have access to health coverage and preventive services like colorectal cancer screening tests. The tests will be available at no additional cost. Visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more.

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