About a Third of US Adults Not Getting Colon Cancer Screenings

About one-third of US adults who should be getting screened for colon cancer aren’t getting screened, according to the Centers for Disease Control and Prevention (CDC). The agency reports that just 65.1% of eligible adult Americans, about two-thirds, are up-to-date with colon cancer screening tests. Of the rest, most have never been screened at all.

Screening is the process of looking for cancer or pre-cancer in people who have no symptoms of the disease. Screening can find colon cancer early, before symptoms develop, when it’s easier to treat. Screening can also sometimes find growths called polyps so they can be removed before they turn into cancer. Fewer people have been dying from colon cancer over the past few decades, partly due to improvements in screening. However, more than 50,000 deaths from colon cancer are expected in 2013, accounting for 9% of all cancer deaths.

The CDC’s findings are reported in the November 5, 2013 issue of Morbidity and Mortality Weekly Report, as well as the November issue of Vital Signs. Researchers used data from the 2012 Behavioral Risk Factor Surveillance System survey to estimate the percentages of Americans aged 50-75 years who were up-to-date with screenings as recommended by the United States Preventive Services Task Force (USPSTF). Like the American Cancer Society, the USPSTF recommends several tests for the prevention or early detection of colon cancer.

American Cancer Society colon cancer screening recommendations

The American Cancer Society recommends regular colon cancer screening starting at age 50 for most people. People with a family history of the disease or other risk factors should talk with their doctor about beginning screening at a younger age.

Several different tests can be used to screen for colon cancer:

Colonoscopy uses a lighted tube to examine the entire length of the colon and rectum. If polyps are found, they can be removed during the test. Before the test, you will need to take medicines to clean out the colon (known as a bowel prep). Most people are sedated during the test. Colonoscopy must be repeated every 10 years.

Flexible sigmoidoscopy is similar to colonoscopy, but examines only part of the colon and rectum. If polyps are found, they may be removed during the test. You may also need to have a colonoscopy later. Most people do not need to be sedated during this test, but bowel prep is needed beforehand. This test must be repeated every 5 years.

Double-contrast barium enema is a type of x-ray test that must be done every 5 years. It requires bowel prep, but no sedation. If suspicious areas are seen on the test, a follow-up colonoscopy will be needed.

CT colonography (also called virtual colonoscopy) is a CT scan of the colon and rectum that produces detailed cross-sectional images so the doctor can look for polyps or cancer. It requires bowel prep, but no sedation. The test must be repeated every 5 years. A regular colonoscopy will be needed if polyps are found.

Fecal occult blood test (FOBT) and fecal immunochemical test (FIT) are used to detect tiny amounts of blood in the stool that could indicate the presence of polyps or cancer. People take either of these tests at home with a kit they receive from their doctor’s office, along with instructions. These tests must be taken every year. A colonoscopy will be needed if blood is found in the stool.

Goal: 80% by 2014

The CDC has set a goal of increasing the colon cancer screening rate to 80% by 2014. To achieve this goal, the CDC is calling for government and community programs to make FOBT and colonoscopy tests available to more people. Those were the tests most frequently used by the people in the survey. About 62% said they’d had colonoscopy, and about 10% used FOBT.

In a briefing, CDC Director Tom Frieden, MD, MPH, said that people are more likely to get screened when they are given more choices about the different tests available, and when their doctors give them clear advice to get screened. He encouraged doctors and health care systems to help increase screening rates by focusing on colon cancer screening as a priority, defining populations who need screening, and creating management teams responsible for carrying out screening programs.

Frieden said it’s important for individuals to learn about the different types of screening, know their family history, and encourage friends and family to get tested. Frieden said, “If you haven’t been screened, see your provider about getting screened. It could save your life.”

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Vital Signs: Colorectal Cancer Screening Test Use – United States, 2012. Published November 5, 2013 in Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report. First author, Carrie N. Klabunde, PhD, National Cancer Institute, Bethesda, Md.

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