PHOM Indicator Profile Report of Colorectal Cancer Screening

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.

Please note: In May 2021, the U.S. Preventive Services Task Force changed its colorectal cancer screening recommendation. The age at which adults at average risk of getting colorectal cancer were recommended to begin screening was lowered from 50 to 45. The data shown here do not include adults younger than age 50.

Data Notes

^ ^*National BRFSS data is published in 5 year age groupings and query by age group 50-75 is not possible, therefore ages 50-74 is used instead. Utah data is also presented for adults ages 50-74 for better comparison to national rates. Due to changes in survey methodology and changes in U.S. Preventive Services Task Force guidelines, only data after 2010 is presented.

Risk Factors

Colorectal cancer risk increases with age, inflammatory bowel disease, a personal or family history of colorectal cancer or polyps, and certain hereditary syndromes. A diet high in fat and low in fiber, lack of regular physical activity, obesity, excessive alcohol consumption, and smoking are also thought to increase risk. A diet high in fruits and vegetables, hormone replacement therapy in post-menopausal women, and aspirin use may reduce colorectal cancer risk.

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.

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.