<i>Vital Signs</i>: Colorectal Cancer Screening Test Use — United States, 2018

TLDR

Colorectal cancer is the second leading cause of cancer death in the U.S., yet screening rates fall short of national targets despite evidence that screening reduces incidence and mortality. The report aims to estimate 2018 CRC screening prevalence among adults 50‑75 by age, demographics, and state. The authors analyzed 2018 BRFSS survey data to calculate the proportion of adults 50‑75 who were up‑to‑date with CRC screening per USPSTF guidelines. In 2018, 68.8% of adults 50‑75 were up‑to‑date with CRC screening, with higher rates among older adults (79.2% for 65‑75 vs 63.3% for 50‑64), lower rates among those without insurance or a regular provider, and state‑level variation from 57.8% in Wyoming to 76.5% in Massachusetts.

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States of cancers that affect both men and women. Despite strong evidence that screening for CRC reduces incidence and mortality, CRC screening prevalence is below the national target. This report describes current CRC screening prevalence by age, various demographic factors, and state.Data from the 2018 Behavioral Risk Factor Surveillance System survey were analyzed to estimate the percentages of adults aged 50-75 years who reported CRC screening consistent with the United States Preventive Services Task Force recommendation.In 2018, 68.8% of adults were up to date with CRC screening. The percentage up to date was 79.2% among respondents aged 65-75 years and 63.3% among those aged 50-64 years. CRC screening prevalence was lowest among persons aged 50-54 years (50.0%) and increased with age. Among respondents aged 50-64 years, CRC screening prevalence was lowest among persons without health insurance (32.6%) and highest among those with reported annual household income of ≥$75,000 (70.8%). Among respondents aged 65-75 years, CRC screening prevalence was lowest among those without a regular health care provider (45.6%), and highest among those with reported annual household income ≥$75,000 (87.1%). Among states, CRC screening prevalence was highest in Massachusetts (76.5%) and lowest in Wyoming (57.8%).CRC screening prevalence is lower among adults aged 50-64 years, although most reported having a health care provider and health insurance. Concerted efforts are needed to inform persons aged <50 years about the benefit of screening so that screening can start at age 50 years.