Colorectal Cancer Screening

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In 2018, 66.8% of adults aged 50-75 had received colorectal cancer screening based on the most recent guidelines.

Summary graph for Colorectal Cancer Screening, Click to see detailed view of graph

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Introduction

The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer for adults aged 50 to 75 years, and adults aged 76 to 85 years should make an individual decision about screening. Regular colorectal cancer screening is important for preventing new colorectal cancers from developing as well as for identifying existing colorectal cancers early - which can reduce the risk of death.  A variety of screening tests can be used to detect colorectal cancer and/or precancerous polyps, including:

  • Colonoscopy - A procedure where a doctor looks into the rectum and the entire colon using a flexible narrow tube to identify colorectal cancer or precancerous polyps. Used not only as a screening test, colonoscopies are also used as a diagnostic procedure to follow up after positive results from a fecal occult blood test (FOBT) or fecal immunochemical test (FIT), fecal DNA test, sigmoidoscopy, or CT colonography. The USPSTF suggests a screening colonoscopy once every 10 years.
  • Computed tomography (CT) colonography (otherwise known as a virtual colonoscopy) - Produces a three-dimensional image of the colon which your doctor examines for colorectal cancer and precancerous polyps. The USPSTF suggests CT colonography once every 5 years.
  • Fecal occult blood test (FOBT) and fecal immunochemical test (FIT) - These tests identify hidden blood in the stool, which can be a sign of cancer. The USPSTF suggests people screen for colorectal cancer annually, using a home-based FOBT or FIT kit.
  • Fecal DNA test – In addition to checking for hidden blood in the stool like a FIT, this test also looks for abnormal genetic material that may be a sign of colorectal cancer. The USPSTF suggests fecal DNA testing at least every 3 years.
  • Sigmoidoscopy - A procedure where a doctor looks into the rectum and part of the colon using a flexible narrow tube to identify colorectal cancer or precancerous polyps. The USPSTF suggests sigmoidoscopy once every 5 years, or once every 10 years when conducted along with FIT every year.
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Measure

Colorectal cancer tests: The percentage of adults aged 50 to 75 years who were up-to-date with colorectal cancer screening. Before 2016, up-to-date was defined as having FOBT every year, a sigmoidoscopy every 5 years in combination with FOBT every 3 years, or a colonoscopy every 10 years. Beginning in 2016, up-to-date is defined as FOBT or FIT every year, fecal DNA testing at least every 3 years, CT colonography every 5 years, flexible sigmoidoscopy alone every 5 years or every 10 years in combination with yearly FIT, or colonoscopy every 10 years.

Colonoscopy or sigmoidoscopy: The percentage of adults aged 50 to 75 years who reported that they had a colonoscopy within the past 10 years or a sigmoidoscopy within the past 5 or 10 (if combined with FIT as of 2016) years, by sex, racial/ethnic group, poverty/income, and education. Rates for colonoscopy and sigmoidoscopy (as direct visualization tests) have been combined into a single measure due to current infrequent use of flexible sigmoidoscopy as a colorectal cancer screening test in the U.S. (≤2% of tests).

CT Colonography: Starting in 2010, the percentage of adults aged 5 to 75 years who reported that they had a CT colonography within the past five years, by sex, racial/ethnic group, poverty/income, and education.

FOBT or FIT: The percentage of adults aged 50 to 75 years who reported that they had a fecal occult blood test (FOBT) or FIT within the past year, by sex, racial/ethnic group, poverty/income, and education. For the 2000 National Health Interview Survey (NHIS), respondents were asked about both home- and office-based FOBTs; starting in 2003, respondents were asked only about home-based FOBTs. Starting in 2015, NHIS respondents were asked about both FOBT and FIT.

Fecal DNA: Starting in 2018, the percentage of adults aged 50 to 75 years who reported that they had a fecal DNA test within the past 3 years, by sex, racial/ethnic group, poverty/income, and education.

Healthy People 2020 Target

  • Increase to 70.5 percent the proportion of adults aged 50 to 75 years who have received a colorectal screening test based on the most recent guidelines.

Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 1987–2018.

Trends and Most Recent EstimatesHelp with navigating the graphs and data tables

Guideline Screening

By Sex
Percentage of adults aged 50-75 years who were up-to-date¹ with colorectal cancer screening by sex, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years  who were up-to-date¹ with colorectal cancer screening by sex, 2000-2018 Both SexesClick to see the detailed trend graph for Both Sexes 66.8 65.6 - 67.9
MaleClick to see the detailed trend graph for Male 67.4 65.7 - 69.0
FemaleClick to see the detailed trend graph for Female 66.3 64.7 - 67.8
By Race/Ethnicity
Percentage of adults aged 50-75 years who were up-to-date¹ with colorectal cancer screening by race/ethnicity, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years  who were up-to-date¹ with colorectal cancer screening by race/ethnicity, 2000-2018 All RacesClick to see the detailed trend graph for All Races 66.8 65.6 - 67.9
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 69.2 67.8 - 70.5
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 65.5 62.1 - 68.8
HispanicClick to see the detailed trend graph for Hispanic 59.0 55.1 - 62.8
By Poverty Income Level
Percentage of adults aged 50-75 years who were up-to-date¹ with colorectal cancer screening by poverty income level, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years  who were up-to-date¹ with colorectal cancer screening by poverty income level, 2000-2018 <200% of federal poverty levelClick to see the detailed trend graph for <200% of federal poverty level 57.1 54.7 - 59.4
>=200% of federal poverty levelClick to see the detailed trend graph for >=200% of federal poverty level 69.8 68.5 - 71.1
By Education Level
Percentage of adults aged 50-75 years who were up-to-date¹ with colorectal cancer screening by highest level of education obtained, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years  who were up-to-date¹ with colorectal cancer screening by highest level of education obtained, 2000-2018 Less than High SchoolClick to see the detailed trend graph for Less than High School 53.2 49.6 - 56.7
High SchoolClick to see the detailed trend graph for High School 63.4 61.1 - 65.5
Greater than High SchoolClick to see the detailed trend graph for Greater than High School 70.7 69.4 - 72.0
By Contributing Test Type
Breakdown of colorectal screening tests received by adults aged 50-75 years by type of screening test received, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Breakdown of colorectal screening tests received by adults aged 50-75 years by type of screening test received, 2000-2018 Home FOBTClick to see the detailed trend graph for Home FOBT 4.2 3.8 - 4.7
Sigmoidoscopy or ColonoscopyClick to see the detailed trend graph for Sigmoidoscopy or Colonoscopy 61.2 60.0 - 62.4
CT ColonographyClick to see the detailed trend graph for CT Colonography 1.0 0.8 - 1.3
Fecal DNA Test 2.7 2.3 - 3.1

Home FOBT

By Sex
Percentage of adults aged 50-75 years who had a home Fecal Occult Blood Test (FOBT) within the past year by sex, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a home Fecal Occult Blood Test (FOBT) within the past year by sex, 2000-2018 Both SexesClick to see the detailed trend graph for Both Sexes 4.2 3.8 - 4.7
MaleClick to see the detailed trend graph for Male 4.2 3.6 - 4.9
FemaleClick to see the detailed trend graph for Female 4.2 3.6 - 5.0
By Race/Ethnicity
Percentage of adults aged 50-75 years who had a home Fecal Occult Blood Test (FOBT) within the past year by race/ethnicity, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a home Fecal Occult Blood Test (FOBT) within the past year by race/ethnicity, 2000-2018 All RacesClick to see the detailed trend graph for All Races 4.2 3.8 - 4.7
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 3.7 3.2 - 4.3
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 3.4 2.4 - 5.0
HispanicClick to see the detailed trend graph for Hispanic 6.4 4.8 - 8.6

Sigmoidoscopy or Colonoscopy

By Sex
Percentage of adults aged 50-75 years who had a sigmoidoscopy in the past 5 years or had a colonoscopy in the past 10 years by sex, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a sigmoidoscopy in the past 5 years or had a colonoscopy in the past 10 years by sex, 2000-2018 Both SexesClick to see the detailed trend graph for Both Sexes 61.2 60.0 - 62.4
MaleClick to see the detailed trend graph for Male 61.8 60.2 - 63.4
FemaleClick to see the detailed trend graph for Female 60.7 59.0 - 62.3
By Race/Ethnicity
Percentage of adults aged 50-75 years who had a sigmoidoscopy in the past 5 years or had a colonoscopy in the past 10 years by race/ethnicity, 2000-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a sigmoidoscopy in the past 5 years or had a colonoscopy in the past 10 years by race/ethnicity, 2000-2018 All RacesClick to see the detailed trend graph for All Races 61.2 60.0 - 62.4
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 64.1 62.7 - 65.5
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 60.1 56.6 - 63.6
HispanicClick to see the detailed trend graph for Hispanic 52.0 48.2 - 55.7

CT Colonography

By Sex
Percentage of adults aged 50-75 years who had a CT colonography in the past 5 years by sex, 2010-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a CT colonography in the past 5 years by sex, 2010-2018 Both SexesClick to see the detailed trend graph for Both Sexes 1.0 0.8 - 1.3
MaleClick to see the detailed trend graph for Male 1.2 0.9 - 1.7
FemaleClick to see the detailed trend graph for Female 0.8 0.6 - 1.1
By Race/Ethnicity
Percentage of adults aged 50-75 years who had a CT colonography in the past 5 years by race/ethnicity, 2010-2018
Overview Graph Detailed Trend Graphs Most Recent Estimates (2018)
Percent of adults 95% Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a CT colonography in the past 5 years by race/ethnicity, 2010-2018 All RacesClick to see the detailed trend graph for All Races 1.0 0.8 - 1.3
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 0.8 0.6 - 1.0
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 1.7 0.9 - 3.0
HispanicClick to see the detailed trend graph for Hispanic 1.9 1.1 - 3.2

Fecal DNA Test

By Sex
Percentage of adults aged 50-75 years who had a home fecal DNA test in the past 3 years by sex
Overview graph Sex 2018
Percent of adults Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a home fecal DNA test in the past 3 years by sex Both Sexes 2.7 2.3 - 3.1
Male 2.4 2.0 - 3.0
Female 2.9 2.4 - 3.4
By Race/Ethnicity
Percentage of adults aged 50-75 years who had a home fecal DNA test in the past 3 years by race/ethnicity
Overview graph Race 2018
Percent of adults Confidence Interval
Thumbnail of graph for Percentage of adults aged 50-75 years who had a home fecal DNA test in the past 3 years by race/ethnicity All Races 2.7 2.3 - 3.1
Non-Hispanic White 2.7 2.3 - 3.2
Non-Hispanic Black 2.8 1.8 - 4.3
Hispanic 2.4 1.3 - 4.1

Evidence-based Resources

Resources are available on colorectal cancer screening to allow for the prioritization of cancer control efforts and the development, implementation and evaluation of cancer control plans. To identify high-risk populations, connect with researchers and practitioners, learn from evidence-based interventions and more, visit Cancer Control P.L.A.N.E.T. –  colorectal cancer.  

Additional Information on Colorectal Cancer Screening

For the public

For health professionals

Scientific reports

Statistics

Year Range

2000-2018

Recent Summary Trend Year Range

2013-2018

Summary Tables

Breast and Cervical Cancers

Recent Summary Trend

Rising

Desired Direction

Rising