Screening for Colorectal Cancer in the United States: Correlates and Time Trends by Type of Test

Abstract

Background: It is strongly recommended that adults aged 50–75 years be screened for colorectal cancer. Recommended screening options include colonoscopy, sigmoidoscopy, CT colonography, guaiac fecal occult blood testing (FOBT), fecal immunochemical testing (FIT), or the more recently introduced FIT-DNA (FIT in combination with a stool DNA test). Colorectal cancer screening programs can benefit from knowledge of patterns of use by test type and within population subgroups. Methods: Using 2018 National Health Interview Survey (NHIS) data, we examined colorectal cancer screening test use for adults aged 50–75 years (N = 10,595). We also examined time trends in colorectal cancer screening test use from 2010–2018. Results: In 2018, an estimated 66.9% of U.S. adults aged 50–75 years had a colorectal cancer screening test within recommended time intervals. However, the prevalence was less than 50% among those aged 50–54 years, those without a usual source of health care, those with no doctor visits in the past year, and those who were uninsured. The test types most commonly used within recommended time intervals were colonoscopy within 10 years (61.1%), FOBT or FIT in the past year (8.8%), and FIT-DNA within 3 years (2.7%). After age-standardization to the 2010 census population, the percentage up-to-date with CRC screening increased from 61.2% in 2015 to 65.3% in 2018, driven by increased use of stool testing, including FIT-DNA. Conclusions: These results show some progress, driven by a modest increase in stool testing. However, colorectal cancer testing remains low in many population subgroups. Impact: These results can inform efforts to achieve population colorectal cancer screening goals.

Evaluation of Colonoscopy and Sigmoidoscopy Utilization for Colorectal Cancer Screening in Georgia, USA

“…In support of the current findings, previously published studies reported rising trends in colonoscopy utilization over time [ 36 , 37 , 38 ]. Shapiro et.…”

Modifications in Primary Care Clinics to Continue Colorectal Cancer Screening Promotion During the COVID-19 Pandemic

“…Among CRC screening test options, colonoscopy is the most frequently used CRC screening test and stool-based tests are the second most frequently used [ 35 , 36 ]. FIT is an annual stool-based test that can be completed at home [ 37 ] and the kits have traditionally been offered to patients during in-person primary care visits.…”

Prevalence of colorectal cancer screening test use by test type and age among older adults in the United States

“…These patterns by test type mirror 2018 test use patterns reported for US adults aged 50-75 years. 3 Colonoscopy was also the most common test used among adults aged 65 years and older in 2000 and 2005. 5 In 2010, colonoscopy was the test type most recommended by physicians for adults aged 76-84 years who had never been screened.…”

“…Traditional analyses of NHIS screening data report test receipt within time intervals corresponding to USPSTF recommendations. [3][4][5] Because we sought to understand current test use at ages 65 years and older, we focused our analyses on tests that occurred no more than 1 year before the interview. We also present estimates of having never received any CRC test.…”