Patterns and predictors of colorectal cancer test use in the adult U.S. population

TLDR

Screening reduces colorectal cancer incidence and mortality, yet educational initiatives and access to primary care are needed to improve uptake. The study used 2000 National Health Interview Survey data to estimate colorectal cancer test use rates and identify associated factors, finding that only 42.5 % of adults aged ≥ 50 had a test within recommended intervals. Test use varied by demographic and socioeconomic factors, with physician visits being the strongest predictor, while lack of awareness and physician recommendation were common barriers; less than half of adults ≥ 50 underwent screening within recommended intervals.

Abstract

Screening is effective in reducing the incidence and mortality of colorectal cancer. Rates of colorectal cancer test use continue to be low.The authors analyzed data from the National Health Interview Survey concerning the use of the home-administered fecal occult blood test (FOBT) and sigmoidoscopy/colonoscopy/proctoscopy to estimate current rates of colorectal cancer test use and to identify factors associated with the use or nonuse of tests.In 2000, 17.1% of respondents reported undergoing a home FOBT within the past year, 33.9% reported undergoing an endoscopy within the previous 10 years, and 42.5% reported undergoing either test within the recommended time intervals. The use of colorectal cancer tests varied by gender, race, ethnicity, age, education, income, health care coverage, and having a usual source of care. Having seen a physician within the past year had the strongest association with test use. Lack of awareness and lack of physician recommendation were the most commonly reported barriers to undergoing such tests.Less than half of the U.S. population age >/= 50 years underwent colorectal cancer tests within the recommended time intervals. Educational initiatives for patients and providers regarding the importance of colorectal cancer screening, efforts to reduce disparities in test use, and ensuring that all persons have access to routine primary care may help increase screening rates.