Colorectal Cancer Screening Rates Remain Low

June 10, 2009

Two studies confirm that colorectal cancer screening is significantly underused in the United States. In a study published online December 10 in Cancer, Gregory Cooper, MD, interim chief of gastroenterology at University Hospitals Case Medical Center in Cleveland and professor of medicine, Case Western Reserve University (CWRU) and the Case Comprehensive Cancer Center, and Tzuyung Doug Kou, MPH, CWRU, assessed a population-based sample of 153,469 Medicare beneficiaries without cancer beginning in 1998, the first year in which colorectal cancer screening was reimbursed under Medicare. The beneficiaries included 17,940 persons with 1 or more risk factors for cancer and 135,529 persons with average risk for cancer.

Two studies confirm that colorectal cancer screening is significantly underused in the United States. In a study published online December 10 in Cancer, Gregory Cooper, MD, interim chief of gastroenterology at University Hospitals Case Medical Center in Cleveland and professor of medicine, Case Western Reserve University (CWRU) and the Case Comprehensive Cancer Center, and Tzuyung Doug Kou, MPH, CWRU, assessed a population-based sample of 153,469 Medicare beneficiaries without cancer beginning in 1998, the first year in which colorectal cancer screening was reimbursed under Medicare. The beneficiaries included 17,940 persons with 1 or more risk factors for cancer and 135,529 persons with average risk for cancer.

The researchers found that between 1991 and 1997, before colorectal cancer screening was reimbursed under Medicare, screening was performed in 29.2% of the sample population. Between 1998 and 2004, only 25% of Medicare beneficiaries were screened for colorectal cancer, despite Medicare coverage for screening. The researchers also found that compared with those who did not receive screening, beneficiaries who were screened between 1991 and 1997 were much more likely to receive subsequent screening between 1998 and 2004.

Recently released findings of a study conducted by the Agency for Healthcare Research and Quality also show low colorectal cancer screening rates. In 2005, only 50% of US adults aged 50 years and older received colorectal cancer screening. Among persons aged 50 to 64 years, 57.5% reported never having been screened compared with 39.4% among those aged 65 years and older. Of those 65 years and older, 41.6% of women reported that they were never screened compared with 36.4% of men.

"These numbers are very discouraging, and unfortunately they confirm previous studies that show not enough people are getting screened for colorectal cancer. This disease is preventable and treatable when caught in its early stages," said Grace Elta, MD, American Society for Gastrointestinal Endoscopy president.