Vital Signs: Colorectal Cancer Screening, Incidence, and Mortality --- United States, 2002--2010

full-text ► Vital Signs: Colorectal Cancer Screening, Incidence, and Mortality --- United States, 2002--2010: "Vital Signs: Colorectal Cancer Screening, Incidence, and Mortality --- United States, 2002--2010
Weekly
July 8, 2011 / 60(26);884-889

On July 5, this report was posted as an MMWR Early Release on the MMWR website (http://www.cdc.gov/mmwr).

Abstract

Background: Screening lowers colorectal cancer (CRC) incidence and mortality. CRC is preventable through the removal of premalignant polyps and is curable if diagnosed early. Increased CRC screening and reduced CRC incidence and mortality are among the Healthy People 2020 objectives.

Methods: CRC screening data are reported using information from 2002--2010 Behavioral Risk Factor Surveillance System surveys. State-specific CRC incidence and mortality data were drawn from the United States Cancer Statistics. Annual percentage changes (APCs) in incidence and death rates from 2003 to 2007 were calculated by state.

Results: From 2002 to 2010, the percentage of persons aged 50--75 years who were adequately screened for colorectal cancer increased from 52.3% to 65.4%. In 2007, CRC incidence ranged from 34.3 per 100,000 population in Utah to 56.9 in North Dakota; death rates ranged from 12.3 per 100,000 in Utah to 21.1 in the District of Columbia (DC). From 2003 to 2007, CRC incidence declined significantly in 35 states, and mortality declined in 49 states and DC, with APCs ranging from 1.0% per year in Alabama to 6.3% per year in Rhode Island.

Conclusions: CRC incidence and mortality have declined in recent years throughout the United States, and CRC screening has increased.

Implications for Public Health Practice: Continued declines in incidence and mortality are expected as past and current public health emphasis on the importance of CRC screening become evident with the increase in screening. To ensure these gains continue, CRC screening should be accessible and used as recommended by all eligible persons in the United States.

Introduction

Colorectal cancer (CRC) is the second most commonly diagnosed cancer and the second leading cause of cancer mortality in the United States among cancers that affect both men and women (1). Strong evidence indicates that screening for CRC reduces the incidence of and mortality from the disease (2). Screening tests for CRC, including fecal occult blood testing (FOBT), sigmoidoscopy, and colonoscopy, used at appropriate intervals, reduce incidence and mortality through prevention (identification and removal of premalignant polyps) and early detection (2). Since 1996, the United States Preventive Services Task Force (USPSTF) and other organizations have recommended CRC screening for persons aged ≥50 years. In 2008, updated guidelines from USPSTF recommended that routine screening continue only until age 75 years, based on review of the risks and benefits of screening (2). Despite the evidence linking CRC screening to lower incidence and mortality, a significant number of age-eligible persons in the United States have not received potentially life-saving screening.

Healthy People 2020 (HP 2020) objectives call for reducing the incidence of CRC to 38.6 per 100,000 population, reducing the death rate to 14.5 per 100,000 population, and increasing the prevalence of CRC screening to 70.5% (3). This report updates CRC screening prevalence data with data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey and presents state-specific data for CRC incidence and death rates for 2007 and annual percentage changes from 2003 to 2007.

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