Colorectal Cancer Screening

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In 2019, 67.1% 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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Background

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, by sex, race/ethnicity, income, education level, and contributing test type. 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 and race/ethnicity. 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 50 to 75 years who reported that they had a CT colonography within the past five years, by sex and race/ethnicity.

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 and race/ethnicity. 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 and race/ethnicity.

Measurement challenges

We track colorectal cancer screening rates in U.S. adults using a large, national, in-person survey in which people are asked about their health behaviors and the medical care they receive (see Data Source, below). There are important limitations to this method that impact what information we can accurately collect and how confident we can be in the findings. Studies have found that certain types of healthcare survey questions can be difficult for people to clearly understand and answer, and it is easy for some questions to be misinterpreted.

In the case of colorectal cancer screening, it can be challenging to determine by self-report alone if an individual received a colonoscopy for the purposes of looking for asymptomatic, previously undetected cancer or precancers (i.e., for screening purposes), or to follow up on symptoms or suspicious findings from a prior test (i.e., for diagnostic purposes). From an individual’s point of view the tests appear similar to the patient experiencing them. Our measure therefore captures general receipt of a colonoscopy (yes/no) more accurately than its underlying purpose. People also may have trouble distinguishing between some of the types of colorectal cancer screening tests available (e.g., FIT versus fecal DNA, flexible sigmoidoscopy versus colonoscopy). Additionally, people may not always accurately recall the specific time they received a particular test. Finally, cancer screening is looking for cancer before a person has symptoms, when they are not known to have had that specific cancer type before. Looking for new or recurrent asymptomatic cancer in a person previously diagnosed and treated for that cancer type represents a different type of testing known as surveillance testing. As people do not always accurately recall what medical tests they have received, the purpose of that testing, or its exact timing, our measure captures any type of colorectal cancer screening received by an individual, and the population may include those with a prior diagnosis of colorectal cancer. Our measure is a reasonable approximation, although an overestimate, of the true U.S. colorectal cancer screening rate, i.e., the measure is not perfectly comparing the actual frequency of adults’ use of colorectal cancer screening tests to national recommendations.

Even though the NHIS colorectal cancer screening measures have limitations, it is the best nationally representative data we have available to assess colorectal cancer screening rates. It is frequently used by governmental and other organizations to track screening use over time in the US.

Healthy People 2030 Target

  • Increase to 74.4 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 2030 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, 1987–2019.

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, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2000-2019 Both SexesClick to see the detailed trend graph for Both Sexes 67.1 66.1 - 68.1
MaleClick to see the detailed trend graph for Male 65.7 64.3 - 67.2
FemaleClick to see the detailed trend graph for Female 68.4 67.1 - 69.7
By Race/Ethnicity
Percentage of adults aged 50-75 years who were up-to-date¹ with colorectal cancer screening by race/ethnicity, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2000-2019 All RacesClick to see the detailed trend graph for All Races 67.1 66.1 - 68.1
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 70.1 69.0 - 71.2
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 68.5 65.8 - 71.1
HispanicClick to see the detailed trend graph for Hispanic 54.7 51.3 - 58.0
By Poverty Income Level
Percentage of adults aged 50-75 years who were up-to-date¹ with colorectal cancer screening by poverty income level, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2000-2019 <200% of federal poverty levelClick to see the detailed trend graph for <200% of federal poverty level 55.4 53.3 - 57.5
>=200% of federal poverty levelClick to see the detailed trend graph for >=200% of federal poverty level 71.3 70.2 - 72.3
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, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2000-2019 Less than High SchoolClick to see the detailed trend graph for Less than High School 50.7 47.2 - 54.3
High SchoolClick to see the detailed trend graph for High School 63.7 61.9 - 65.4
Greater than High SchoolClick to see the detailed trend graph for Greater than High School 72.3 71.1 - 73.4
By Contributing Test Type
Breakdown of colorectal screening tests received by adults aged 50-75 years by type of screening test received, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2000-2019 Home FOBTClick to see the detailed trend graph for Home FOBT 3.3 3.0 - 3.7
Sigmoidoscopy or ColonoscopyClick to see the detailed trend graph for Sigmoidoscopy or Colonoscopy 63.1 62.1 - 64.2
CT ColonographyClick to see the detailed trend graph for CT Colonography 1.2 1.0 - 1.5
CologuardClick to see the detailed trend graph for Cologuard 2.4 2.1 - 2.8

Home FOBT or FIT

By Sex
Percentage of adults aged 50-75 years who had a home fecal occult blood test (FOBT) or fecal immunochemical test (FIT) within the past year by sex, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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) or fecal immunochemical test (FIT) within the past year by sex, 2000-2019 Both SexesClick to see the detailed trend graph for Both Sexes 3.3 3.0 - 3.7
MaleClick to see the detailed trend graph for Male 2.9 2.4 - 3.4
FemaleClick to see the detailed trend graph for Female 3.8 3.2 - 4.4
By Race/Ethnicity
Percentage of adults aged 50-75 years who had a home fecal occult blood test (FOBT) or fecal immunochemical test (FIT) within the past year by race/ethnicity, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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) or fecal immunochemical test (FIT) within the past year by race/ethnicity, 2000-2019 All RacesClick to see the detailed trend graph for All Races 3.3 3.0 - 3.7
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 3.1 2.7 - 3.5
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 2.5 1.7 - 3.7
HispanicClick to see the detailed trend graph for Hispanic 5.1 3.9 - 6.6

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, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2000-2019 Both SexesClick to see the detailed trend graph for Both Sexes 63.1 62.1 - 64.2
MaleClick to see the detailed trend graph for Male 62.1 60.6 - 63.6
FemaleClick to see the detailed trend graph for Female 64.1 62.7 - 65.5
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, 2000-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2000-2019 All RacesClick to see the detailed trend graph for All Races 63.1 62.1 - 64.2
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 66.4 65.2 - 67.6
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 65.3 62.5 - 68.0
HispanicClick to see the detailed trend graph for Hispanic 48.8 45.6 - 52.0

CT Colonography

By Sex
Percentage of adults aged 50-75 years who had a CT colonography in the past 5 years by sex, 2010-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2010-2019 Both SexesClick to see the detailed trend graph for Both Sexes 1.2 1.0 - 1.5
MaleClick to see the detailed trend graph for Male 1.3 1.0 - 1.7
FemaleClick to see the detailed trend graph for Female 1.1 0.8 - 1.5
By Race/Ethnicity
Percentage of adults aged 50-75 years who had a CT colonography in the past 5 years by race/ethnicity, 2010-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
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, 2010-2019 All RacesClick to see the detailed trend graph for All Races 1.2 1.0 - 1.5
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 0.9 0.8 - 1.2
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 2.5 1.7 - 3.6
HispanicClick to see the detailed trend graph for Hispanic 2.4 1.5 - 3.9

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, 2018-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
Percent of adults 95% 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, 2018-2019 Both SexesClick to see the detailed trend graph for Both Sexes 2.4 2.1 - 2.8
MaleClick to see the detailed trend graph for Male 2.3 1.9 - 2.8
FemaleClick to see the detailed trend graph for Female 2.5 2.1 - 3.0
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, 2018-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
Percent of adults 95% 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, 2018-2019 All RacesClick to see the detailed trend graph for All Races 2.4 2.1 - 2.8
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 2.6 2.2 - 3.1
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 2.8 1.8 - 4.3
HispanicClick to see the detailed trend graph for Hispanic 1.6 0.9 - 2.6

Additional Information on Colorectal Cancer Screening

Year Range

2000-2019

Recent Summary Trend Year Range

2015-2019

Summary Tables

Breast and Cervical Cancers

Recent Summary Trend

Rising

Desired Direction

Rising