Despite the fact that research shows colorectal cancer (CRC) screening saves lives, screening rates remain far too low, according to CDC Director Thomas Frieden, M.D., M.P.H.
"About one in three adults aged 50 to 75 have not been screened as recommended by the U.S. Preventive Services Task Force (USPSTF)," Frieden said in a Nov. 5 media briefing(www.cdc.gov) that recapped a CDC Vital Signs report(www.cdc.gov) on CRC screening recently published in Morbidity and Mortality Weekly Report. "That translates to 23 million people -- 23 million people who are at risk from preventable colon cancer."
As the second-leading cancer killer among both men and women and the leading killer of nonsmokers in this country, CRC is responsible for roughly 50,000 deaths each year. Because screening works and because different test options exist, the medical establishment needs to find a way to increase the number of people getting tested, Frieden said.
"The bottom line is, the best test is the test that gets done," he said. "We want adults age 50 and older to get screened for colon cancer because that saves lives."
The screening options available -- colonoscopy, the fecal occult blood test and the fecal immunochemical test -- are all good ones, Frieden said, and studies show that when people are given more choices, they're more likely to get screened. But it's still up to physicians to offer those options.
"More choices will lead to more progress," said Frieden. "So there's an opportunity to further increase colorectal screening and save more lives. We encourage health care providers to talk with their patients about colon cancer screening and about the choice of tests."
According to the report, although more than 65 percent of U.S. adults overall were up-to-date with CRC screening, individual states' percentages varied by about 10 percent plus or minus. Massachusetts set the standard, with more than 76 percent of eligible adults screened, while Arkansas, at 55.7 percent, and Wyoming, at 55.9 percent, brought up the rear.
"So, where you live, unfortunately, determines far too much whether you're going to get screened for and get your colon cancer prevented," said Frieden. "We've learned that most states with higher overall screening rates also had a relatively higher use of both fecal tests and colonoscopy, and we believe that there are key approaches that can result in increased screening rates, more cancer prevented, more lives saved."
Frieden said he hopes health care systems will work to expand the use of organized screening systems to identify everyone who is eligible for screening. He also pointed out that the CDC provides funding to 25 states and four American Indian tribes to increase CRC screening rates and urged the public health community to increase communication and outreach, as well as to find other ways to inform people about the importance of CRC screening.
The AAFP, along with the USPSTF, recommends screening adults for colorectal cancer using fecal occult blood testing, sigmoidoscopy or colonoscopy beginning at age 50 and continuing until age 75. The USPSTF outlines and compares risks and benefits of the different screening modalities in the clinical summary(www.uspreventiveservicestaskforce.org) of its recommendation statement.