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In 2018, 66.8% of adults aged 50-75 had received colorectal cancer screening based on the most recent guidelines.
Introduction
The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer for adults aged 50 to 75 years, and adults aged 76 to 85 years should make an individual decision about screening. Regular colorectal cancer screening is important for preventing new colorectal cancers from developing as well as for identifying existing colorectal cancers early - which can reduce the risk of death. A variety of screening tests can be used to detect colorectal cancer and/or precancerous polyps, including:
- Colonoscopy - A procedure where a doctor looks into the rectum and the entire colon using a flexible narrow tube to identify colorectal cancer or precancerous polyps. Used not only as a screening test, colonoscopies are also used as a diagnostic procedure to follow up after positive results from a fecal occult blood test (FOBT) or fecal immunochemical test (FIT), fecal DNA test, sigmoidoscopy, or CT colonography. The USPSTF suggests a screening colonoscopy once every 10 years.
- Computed tomography (CT) colonography (otherwise known as a virtual colonoscopy) - Produces a three-dimensional image of the colon which your doctor examines for colorectal cancer and precancerous polyps. The USPSTF suggests CT colonography once every 5 years.
- Fecal occult blood test (FOBT) and fecal immunochemical test (FIT) - These tests identify hidden blood in the stool, which can be a sign of cancer. The USPSTF suggests people screen for colorectal cancer annually, using a home-based FOBT or FIT kit.
- Fecal DNA test – In addition to checking for hidden blood in the stool like a FIT, this test also looks for abnormal genetic material that may be a sign of colorectal cancer. The USPSTF suggests fecal DNA testing at least every 3 years.
- Sigmoidoscopy - A procedure where a doctor looks into the rectum and part of the colon using a flexible narrow tube to identify colorectal cancer or precancerous polyps. The USPSTF suggests sigmoidoscopy once every 5 years, or once every 10 years when conducted along with FIT every year.
Measure
Colorectal cancer tests: The percentage of adults aged 50 to 75 years who were up-to-date with colorectal cancer screening. Before 2016, up-to-date was defined as having FOBT every year, a sigmoidoscopy every 5 years in combination with FOBT every 3 years, or a colonoscopy every 10 years. Beginning in 2016, up-to-date is defined as FOBT or FIT every year, fecal DNA testing at least every 3 years, CT colonography every 5 years, flexible sigmoidoscopy alone every 5 years or every 10 years in combination with yearly FIT, or colonoscopy every 10 years.
Colonoscopy or sigmoidoscopy: The percentage of adults aged 50 to 75 years who reported that they had a colonoscopy within the past 10 years or a sigmoidoscopy within the past 5 or 10 (if combined with FIT as of 2016) years, by sex, racial/ethnic group, poverty/income, and education. Rates for colonoscopy and sigmoidoscopy (as direct visualization tests) have been combined into a single measure due to current infrequent use of flexible sigmoidoscopy as a colorectal cancer screening test in the U.S. (≤2% of tests).
CT Colonography: Starting in 2010, the percentage of adults aged 5 to 75 years who reported that they had a CT colonography within the past five years, by sex, racial/ethnic group, poverty/income, and education.
FOBT or FIT: The percentage of adults aged 50 to 75 years who reported that they had a fecal occult blood test (FOBT) or FIT within the past year, by sex, racial/ethnic group, poverty/income, and education. For the 2000 National Health Interview Survey (NHIS), respondents were asked about both home- and office-based FOBTs; starting in 2003, respondents were asked only about home-based FOBTs. Starting in 2015, NHIS respondents were asked about both FOBT and FIT.
Fecal DNA: Starting in 2018, the percentage of adults aged 50 to 75 years who reported that they had a fecal DNA test within the past 3 years, by sex, racial/ethnic group, poverty/income, and education.
Healthy People 2020 Target
- Increase to 70.5 percent the proportion of adults aged 50 to 75 years who have received a colorectal screening test based on the most recent guidelines.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 1987–2018.
Trends and Most Recent Estimates
Guideline Screening
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
66.8 | 65.6 - 67.9 |
Male
|
67.4 | 65.7 - 69.0 | |
Female
|
66.3 | 64.7 - 67.8 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
66.8 | 65.6 - 67.9 |
Non-Hispanic White
|
69.2 | 67.8 - 70.5 | |
Non-Hispanic Black
|
65.5 | 62.1 - 68.8 | |
Hispanic
|
59.0 | 55.1 - 62.8 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
57.1 | 54.7 - 59.4 |
>=200% of federal poverty level
|
69.8 | 68.5 - 71.1 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
53.2 | 49.6 - 56.7 |
High School
|
63.4 | 61.1 - 65.5 | |
Greater than High School
|
70.7 | 69.4 - 72.0 | |
By Contributing Test Type
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Home FOBT
|
4.2 | 3.8 - 4.7 |
Sigmoidoscopy or Colonoscopy
|
61.2 | 60.0 - 62.4 | |
CT Colonography
|
1.0 | 0.8 - 1.3 | |
| Fecal DNA Test | 2.7 | 2.3 - 3.1 | |
Home FOBT
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
4.2 | 3.8 - 4.7 |
Male
|
4.2 | 3.6 - 4.9 | |
Female
|
4.2 | 3.6 - 5.0 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
4.2 | 3.8 - 4.7 |
Non-Hispanic White
|
3.7 | 3.2 - 4.3 | |
Non-Hispanic Black
|
3.4 | 2.4 - 5.0 | |
Hispanic
|
6.4 | 4.8 - 8.6 | |
Sigmoidoscopy or Colonoscopy
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
61.2 | 60.0 - 62.4 |
Male
|
61.8 | 60.2 - 63.4 | |
Female
|
60.7 | 59.0 - 62.3 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
61.2 | 60.0 - 62.4 |
Non-Hispanic White
|
64.1 | 62.7 - 65.5 | |
Non-Hispanic Black
|
60.1 | 56.6 - 63.6 | |
Hispanic
|
52.0 | 48.2 - 55.7 | |
CT Colonography
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
1.0 | 0.8 - 1.3 |
Male
|
1.2 | 0.9 - 1.7 | |
Female
|
0.8 | 0.6 - 1.1 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
1.0 | 0.8 - 1.3 |
Non-Hispanic White
|
0.8 | 0.6 - 1.0 | |
Non-Hispanic Black
|
1.7 | 0.9 - 3.0 | |
Hispanic
|
1.9 | 1.1 - 3.2 | |
Fecal DNA Test
By Sex
| Overview graph | Sex | 2018 | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
Both Sexes | 2.7 | 2.3 - 3.1 |
| Male | 2.4 | 2.0 - 3.0 | |
| Female | 2.9 | 2.4 - 3.4 | |
By Race/Ethnicity
| Overview graph | Race | 2018 | |
|---|---|---|---|
| Percent of adults | Confidence Interval | ||
|
All Races | 2.7 | 2.3 - 3.1 |
| Non-Hispanic White | 2.7 | 2.3 - 3.2 | |
| Non-Hispanic Black | 2.8 | 1.8 - 4.3 | |
| Hispanic | 2.4 | 1.3 - 4.1 | |
Evidence-based Resources
Resources are available on colorectal cancer screening to allow for the prioritization of cancer control efforts and the development, implementation and evaluation of cancer control plans. To identify high-risk populations, connect with researchers and practitioners, learn from evidence-based interventions and more, visit Cancer Control P.L.A.N.E.T. – colorectal cancer.
Additional Information on Colorectal Cancer Screening
For the public
- Colorectal Cancer Screening (PDQ®)-Patient Version. National Cancer Institute.
- Colorectal Cancer Prevention (PDQ®) – Patient Version. National Cancer Institute.
- Tests to Detect Colorectal Cancer and Polyps. National Cancer Institute.
- Medicare Coverage for Cancer Prevention and Early Detection. American Cancer Society.
- Colorectal (Colon) Cancer. Centers for Disease Control and Prevention.
For health professionals
- Colorectal Cancer Screening (PDQ®)-Health Professional Version. National Cancer Institute.
- Colorectal Cancer: Screening (June 2016). U.S. Preventive Services Task Force.
- The Community Guide: Cancer. Centers for Disease Control and Prevention, Community Preventive Services Task Force.
Scientific reports
- Evaluating screening participation, follow-up, and outcomes for breast, cervical, and colorectal cancer in the PROSPR consortium. Barlow WE, Beaber EF, Geller BM, et al. J Natl Cancer Inst 2019; djz137.
- Screening for colorectal cancer: A systematic review and meta-analysis. Fitzpatrick-Lewis D, Ali MU, Warren R, et al. Clin Colorectal Cancer 2016; 15(4): 298-313.
- Performance Characteristics of Fecal Immunochemical Tests for Colorectal Cancer and Advanced Adenomatous Polyps: A Systematic Review and Meta-analysis. Imperiale TF, Gruber RN, Stump TE, et al. Ann Intern Med 2019; 170 (5): 319-329.
- Screening for colorectal cancer: Updated evidence report and systematic review for the U.S. Preventive Services Task Force. Lin JS, Piper MA, Perdue LA, et al. JAMA 2016; 315(23): 2576-94.
- Effect of digital health intervention on receipt of colorectal cancer screening in vulnerable patients: a randomized controlled trial. Miller DP Jr, Denizard-Thompson N, Weaver KE et al. Ann Intern Med 2018 Apr 17; 168(8): 550-557.
- Screening for colorectal cancer: the role of the primary care physician. Triantafillidis JK, Vagianos C, Gikas A, Korontzi M, Papalois A. Eur J Gastroenterol Hepatol. 2016 Sep 26.
- Interventions to increase uptake of faecal tests for colorectal cancer screening: a systematic review. Rat C, Latour C, Rousseau R et al. Eur J Cancer Prev 2018 May; 27(3):227-236.
Statistics
- SEER Cancer Stat Facts: Colorectal Cancer. National Cancer Institute.
- Behavioral Risk Factor Surveillance System: Prevalence Data & Data Analysis Tools. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.