Colorectal screening is increasing, but not enough

Although colorecetal cancer screening rose from 52% in 2002 to 65% in 2010, that still leaves approximately one-third of adults untested, according to a new report from the CDC.

The agency compiled 2002–2010 data from the state-level Behavioral Risk Factor Surveillance System to produce Vital Signs: Colorectal Cancer Screening, Incidence, and Mortality—United States, 2002–2010 (www.cdc.gov/VitalSigns/CancerScreening/index.html). The report indicates that if the Healthy People 2020 target of 70.5% for colorectal cancer screening in the United States is met, nearly 1,000 additional colorectal cancer deaths will be prevented annually.

The CDC document lists the following reasons for lack of screening: a health care provider did not advise the person to be screened, the person does not realize that everyone's risk increases with age, the person has no health insurance or no health care provider, the person fears the test and/or fears the test will be positive for cancer.

The CDC expects the Affordable Care Act to increase colorectal cancer screening rates, in part by eliminating all cost-sharing for colorectal cancer screening covered by Medicare and by requiring new health insurance plans to cover the test with no cost-sharing.

The Vital Signs report also includes the following highlights regarding colorectal cancer:

  • The rate of new cases fell from 52.3 per 100,000 in 2003 to 45.4 per 100,000 in 2007, representing nearly 66,000 fewer cancers. “Half of these prevented cases and deaths were due to screening,” asserts the report.
  • The colorectal cancer death rate fell from 19.0 per 100,000 in 2003 to 16.7 per 100,000 in 2007, representing nearly 32,000 fewer deaths.
  • Most states had reductions in colorectal cancer incidence and mortality consistent with improvements in screening.
  • North Dakota reported the highest colorectal cancer incidence rate (56.9 per 100,000) and Utah, the lowest (34.3 per 100,000).
  • Washington, DC, reported the highest colorectal cancer death rate (21.1 per 100,000) and Colorado and Montana, the lowest (14.1 per 100,000).
  • Generally, colorectal cancer incidence and mortality were higher in the Midwest and the South.
  • The estimated direct medical cost of colorectal cancer was $14 billion in 2010.
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