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Trends in colorectal cancer test use among vulnerable populations in the United States

. 2011 Aug;20(8):1611-21. doi: 10.1158/1055-9965.EPI-11-0220. Epub 2011 Jun 8. Trends in colorectal cancer test use among vulnerable populations in the United States

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Trends in colorectal cancer test use among vulnerable populations in the United States

Carrie N Klabunde et al. Cancer Epidemiol Biomarkers Prev. 2011 Aug.

. 2011 Aug;20(8):1611-21. doi: 10.1158/1055-9965.EPI-11-0220. Epub 2011 Jun 8. Affiliation

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Abstract

Background: Evaluating trends in colorectal cancer (CRC) screening use is critical for understanding screening implementation, and whether population groups targeted for screening are receiving it, consistent with guidelines. This study examines recent national trends in CRC test use, including among vulnerable populations.

Methods: We used the 2000, 2003, 2005, and 2008 National Health Interview Survey to examine national trends in CRC screening use overall and for fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy. We also assessed trends by race/ethnicity, educational attainment, income, time in the United States, and access to health care.

Results: During 2000 to 2008, significant declines in FOBT and sigmoidoscopy use and significant increases in colonoscopy use and in the percentages of adults up-to-date with CRC screening occurred overall and for most population subgroups. Subgroups with consistently lower rates of colonoscopy use and being up-to-date included Hispanics; people with minimal education, low income, or no health insurance; recent immigrants; and those with no usual source of care or physician visits in the past year. Among up-to-date adults, there were few subgroup differences in the type of test by which they were up-to-date (i.e., FOBT, sigmoidoscopy, or colonoscopy).

Conclusions: Although use of CRC screening and colonoscopy increased among U.S. adults, including those from vulnerable populations, 45% of adults aged 50 to 75-or nearly 35 million people-were not up-to-date with screening in 2008.

Impact: Continued monitoring of CRC screening rates among population subgroups with consistently low utilization is imperative. Improvement in CRC screening rates among all population groups in the United States is still needed.

©2011 AACR.

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Figures

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Type of Colorectal Cancer Test…

Figure 1

Type of Colorectal Cancer Test used by U.S. Adults 50–75 who met Colorectal…

Figure 1

Type of Colorectal Cancer Test used by U.S. Adults 50–75 who met Colorectal Cancer Screening Guidelines1 1Had home FOBT in the past year, sigmoidoscopy in the past 5 years, and/or colonoscopy in the past 10 years. 2Data in this panel are restricted to people aged 50–64.

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