Important Facts for Colorectal Cancer Screening

Definition

The proportion of respondents ages 50-75 who reported having recommended colorectal cancer screening (sigmoidoscopy or colonoscopy in the past 10 years or having an FOBT [fecal occult blood test] in the last year).

Numerator

The number of respondents ages 50-75 reported having recommended colorectal cancer screening (sigmoidoscopy or colonoscopy in the past 10 years or having an FOBT [fecal occult blood test] in the last year).

Denominator

The total number of survey respondents aged 50-75 excluding those who answered "don't know" or "refused" to the numerator question.

Data Interpretation Issues

To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. In 2016 age distribution changed from 8 age groups to 5 age groups. This change in methodology may affect interpretation of data trends.

Why Is This Important?

Colorectal cancer is one of the leading causes of cancer-related deaths in the U.S. and Utah. Screening for this cancer is important as deaths can be substantially reduced when precancerous polyps are detected at early stages and removed. The chance of surviving colorectal cancer exceeds 90% when the cancer is diagnosed before it has extended beyond the intestinal wall ([http://www.cancer.org]). The U.S. Preventive Services Task Force recommends that routine screening for colorectal cancer begin at age 45 for adults at average risk. Persons at high risk may need to begin screening at a younger age. Routine screening can include either an annual fecal occult blood test (FOBT), a flexible sigmoidoscopy every five years, a colonoscopy every 10 years, or a double-contrast barium enema every 5 to 10 years.

Other Objectives

CSTE Chronic Disease Indicators Similar to HP2020 Objective C-16: Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines.

How Are We Doing?

Colorectal cancer screening rates in Utah have generally increased over the last decade, with a screening rate of 62.3% in 2010 increasing to a rate of 74.1% in 2020 among adults aged 50-74. Colorectal cancer screening rates across the state vary by geography and other sociodemographic factors. Among local health districts (LHDs) in 2020, San Juan LHD (42.7%), TriCounty LHD (50.1%), and Southeast Utah LHD (64.6%) had significantly lower colorectal cancer screening rates than the state average (74.3%). See additional data views for more specific differences between Utah Small Areas. In 2020, Hispanic adults aged 50-75 were significantly less likely (59.1%) than non-Hispanic adults (76.1%) to report having completed the recommended colorectal cancer screening. Those who racially identified as Asian (57.3%) or American Indian/Alaskan Native (53.1%) were also significantly less likely to report having completed the recommended colorectal cancer screening compared to all races (72.1%) for combined years 2016, 2018, and 2020. In 2020, those who reported having received less than a high school education were screened for colorectal cancer at significantly lower rates (53.4%) than others who had more education. Average colorectal cancer screening rates increased with each additional education level attained. Also in 2020, those who reported an annual household income of less than $25,000 were significantly less likely to report having completed a recommended colorectal cancer screening (63.2%) compared to those with higher incomes. Adults aged 65-75 were significantly more likely to report having received a recommended colorectal cancer screening (84.4%) than adults aged 50-64 (69.0%) based on 2020 BRFSS data. There was no significant difference in colorectal cancer screening rates between males and females.

How Do We Compare With the U.S.?

Nationally, the percentage of adults aged 50-74 completing recommended colorectal cancer screening was 73.9% in 2020, compared to the Utah screening rate of 74.1%. Current data appears to parallel previously seen trends, with Utah screening rates being comparable to the U.S. average.

What Is Being Done?

Screening for colorectal cancer has recently been identified by the Centers for Disease Control and Prevention (CDC) as a priority public health issue.

Health Program Information

The mission of the Utah Cancer Coalition is to lower cancer incidence, morbidity, and mortality in Utah through collaborative efforts directed toward cancer prevention and control. As a result, they support community-based strategies around food security, healthy neighborhoods, access to healthcare, and financial toxicity in order to prevent cancer; detect cancer early; and improve the lives of cancer survivors, caregivers, and their families.