CDC says colorectal cancer screening rates remain low

Colorectal cancer screening rates in the United States remain low despite evidence that shows that at least a third of deaths due to colorectal cancer could be prevented if people 50 years and older are screened regularly, according to data released today by the Centers for Disease Control and Prevention (CDC).

The proportion of U.S. men and women aged 50 and older who reported having had a fecal occult blood test was 20.6% in 1999, and the proportion who reported having had a sigmoidoscopy or colonoscopy within the previous 5 years was 33.6%, according to data published in the March 9, 2001 issue of Morbidity and Mortality Weekly Report.

"We are losing too many lives to a disease which can be prevented in many instances," said CDC Director Jeffrey P. Koplan, M.D., M.P.H.. "We must renew our efforts to educate Americans and their health care providers that colorectal cancer screening saves lives."

CDC recommends that men and women begin regular colorectal cancer screening when they turn 50. Deciding which screening test to use depends on a person's risk for colorectal cancer and should be made in consultation with a health care provider.

Colorectal cancer is the second leading cancer killer in the United States, and men and women are both at risk. In 2001, an estimated 56,700 people will die from colorectal cancer even though screening could find the abnormal growths, called polyps, that cause the disease. Polyps can be removed before they turn into cancer.

Medicare currently covers four types of colorectal cancer screening tests — fecal occult blood tests annually, flexible sigmoidoscopies every four years, colonoscopies every two years for beneficiaries with high risk of colon cancer, and barium enemas as an alternative to either colonoscopies (one every two years) for high risk individuals, or flexible sigmoidoscopies (one every four years).

The screening fecal occult blood tests and flexible sigmoidoscopy exams are available to Medicare beneficiaries age 50 or older. There is no age limit for colonoscopies.

In addition, the recently enacted Beneficiary Improvement and Protection Act (BIPA) added coverage effective July 1, 2001 for screening colonoscopies once every 10 years for beneficiaries not at high risk for colorectal cancer.

Although embarrassment and discomfort have been cited by some who avoid the screening, other possible reasons not to be screened may include lack of knowledge by the public and health care providers of the effectiveness of screening and low reimbursement rates for screening tests, according to the CDC.

"Screening saves lives," said CDC's Laura C. Seeff, M.D., the author of the report. "Ninety percent of the people whose colorectal cancer is found and treated early survive."

In recognition of National Colorectal Cancer Awareness Month, CDC and the Health Care Financing Administration released today new materials for their program Screen for Life: A National Colorectal Cancer Action Campaign, including public service announcements (available online at www.cdc.gov/cancer/screenforlife). In addition, A Call to Action: Prevention and Early Detection of Colorectal Cancer, a comprehensive slide presentation for health care providers, is available online at www.cdc.gov/cancer/colorctl/calltoaction.

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