Rates and predictors of colorectal cancer screening.
BACKGROUND
Despite widespread recommendations for colorectal cancer screening, the U.S. screening rate is low. The objectives of this study were to describe the rates and predictors of colorectal cancer screening use by examining groups in two categories--1) those who have ever been screened and 2) those with up-to-date screening--and to assess whether trends and predictors change over time.


METHODS
We analyzed data from the 2000 and 2003 National Health Interview Surveys about the use of fecal occult blood tests, sigmoidoscopies, and colonoscopies for adults aged 50 years and older and without a history of colorectal cancer (N = 11,574 in 2000 and N = 11,779 in 2003).


RESULTS
Rates in the 2000 study population of those who have ever been screened for colorectal cancer (53%) had increased in the 2003 study population (55%) as had the rates in the 2003 study population of those with up-to-date colorectal screening (53%) compared with the rates in the 2000 study population (38%). Among those who were ever screened, 76% were up-to-date with screening in 2003, compared with 68% in 2000. There was increased use of colonoscopies but decreased use of fecal occult blood tests and sigmoidoscopies. Individuals were more likely to be up-to-date with screening if they had higher income, higher education, insurance coverage, a usual source of care, and a dental visit in the last year than if these predictors were not evident. Since 2000, these predictors of colorectal cancer screening use have remained stable.


CONCLUSIONS
Although there has been relatively limited success in increasing overall screening, it is encouraging that most people in the group of those who have ever been screened are up-to-date with colorectal cancer screening. Predictors for colorectal screening were stable over time despite changes in screening policies and rates. Further research is needed to uncover barriers to colorectal cancer screening.
Liang
Su-Ying
SY
School of Pharmacy, University of California, San Francisco, 3333 California St, Suite 420, Box 0613, San Francisco, CA 94143, USA. liangs@pharmacy.ucsf.edu
Phillips
Kathryn A
KA
Nagamine
Mika
M
Ladabaum
Uri
U
Haas
Jennifer S
JS
D000328:Adult; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data / Q000639:trends; D008875:Middle Aged; D009780:Occult Blood; D014481:United States