title: Longitudinal adherence to colorectal cancer screening guidelines.
abstract: OBJECTIVE
  To describe adherence with United States Preventive Services Task Force (USPSTF) colorectal cancer (CRC) screening recommendations over a 10-year period in a large, continuously insured screening population at average risk for CRC.
  
  
  METHODS
  Retrospective claims database analysis.
  
  
  METHODS
  Insured members (N = 151,638) who turned 50 years old between January 1, 2000, and December 31, 2004, and were at average risk for CRC were included in the analysis. Subjects were categorized as adherent, inadequately screened, or screening-naïve based on their level of adherence with USPSTF CRC screening guidelines. Outcomes considered were age at initial CRC screening and CRC screening tests received over the 10-year period.
  
  
  RESULTS
  Of the 151,638 subjects in the cohort, only 97,518 (64%) were adherent with current CRC screening recommendations. An additional 18,050 (12%) were considered inadequately screened and 36,070 (24%) were screening-naïve. In those subjects who received some form of CRC screening, the average age at screening initiation was 53 years--3 years past the age recommended by current guidelines. Of those subjects who were inadequately screened, nearly half (46%) received only 1 fecal occult blood or fecal immunochemical test over the 10-year period.
  
  
  CONCLUSIONS
  In a sample of continuously insured average-risk individuals aged 50 to 54 years, CRC screening was initiated later and performed less frequently than recommended in USPSTF guidelines.
authors.forename: Anissa
authors.initials: A
authors.lastname: Cyhaniuk
authors.affiliation: Hoffmann-La Roche Limited, 7070 Mississauga Road, Mississauga, ON, Canada L5N 5M8. E-mail: megan.coombes@roche.com.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Coombes
mesh_terms: D000367:Age Factors; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States