The CDC analyzed data from the 1997 Behavioral Risk Factor Surveillance System (BRFSS) on the use of the fecal occult blood test (FOBT), and sigmoidoscopy or proctoscopy to estimate the proportion, or number of Americans who had received these screening tests.

In a 1997 random phone survey, 52,754 persons aged 50 or more were asked if they had ever had a FOBT using a home kit, whether they had ever had a sigmoidoscopy or proctoscopy, and if so, when the last test had been performed.

"Overall, 39.7 percent of respondents reported ever having FOBT, and 41.7 percent reported ever having had sigmoidoscopy or proctoscopy," the study reported. "For this report, all results refer to tests received during the recommended time period."

The researchers also found:

• Nearly 20 percent of the survey respondents reported having a FOTB during the preceding year.
• Thirty percent reported having sigmoidoscopy or proctoscopy during the preceding five years.
• Men were more likely than women to report they had a sigmoidoscopy or proctoscopy but women were more likely to have had a FOBT.
• Fewer American Indians/Alaskan natives and Asian/Pacific Islanders reported having a FOBT than whites and African-Americans. Hispanics were less likely to have either test.
• The number of persons who had either test increased with age until they were 79, then the number decreased for persons age 80 and over.

The authors felt there were three limitations to this survey: only people with telephones are represented; people reported on themselves and findings have not been validated; and because the BRFSS questionnaire did not distinguish these tests as either screening or diagnostic, so the rate of use for these tests as screening mechanisms are probably lower than reported.

The report said both patient and provider barriers contribute to low screening rates. The lack of knowledge of screening recommendations, access to health care, anticipated discomfort, and embarrassment may be reasons patients do not have either of these tests performed. Barriers by providers may include lack of skills and lack of time to counsel patients about this issue.

In hopes of boosting the numbers of people getting screened for colorectal cancer, the CDC has launched a comprehensive awareness campaign to educate consumers and health care providers about the importance of screening and to encourage patients to discuss this with their physicians.