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Colorectal Cancer Test Use from the 2005 National Health Interview Survey

¹ Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; ² Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and ³ Division of Health Promotion and Behavioral Sciences, University of Texas-Houston School of Public Health, Houston, Texas

Requests for reprints: Jean A. Shapiro, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway Northeast, Mailstop K-55, Atlanta, GA 30341-3717. Phone: 770-488-3010; Fax: 770-488-4639. E-mail: zga9{at}cdc.gov

Background: Screening is effective in reducing colorectal cancer mortality. Recommended colorectal cancer screening options include a home fecal occult blood test (FOBT) or colorectal endoscopy (sigmoidoscopy or colonoscopy). Past surveys have indicated that colorectal cancer screening prevalence in the United States is low. The purpose of this analysis was to determine the prevalence of colorectal cancer test use in the United States by various factors and to examine reasons for not having a colorectal cancer test.

Methods: Data on respondents ages 50 years from the 2005 National Health Interview Survey (n = 13,269) were analyzed. The proportion of the U.S. population that had home FOBT within the past year or endoscopy within the past 10 years was examined by sociodemographic, health-care access, and other health-related factors. Reported reasons for not having FOBT or endoscopy were also analyzed.

Results: The age-standardized proportion of respondents who reported FOBT within the past year and/or endoscopy within the past 10 years was 50.0% [95% confidence interval (95% CI), 48.8-51.2]. Colorectal cancer testing rates were particularly low among people without health-care coverage (24.1%; 95% CI, 19.2-29.7) or without a usual source of health care (24.7%; 95% CI, 20.8-29.0). The most commonly reported reason for not having a colorectal cancer test was "never thought about it."

Conclusions: In 2005, about half of Americans ages 50 years did not have appropriate colorectal cancer testing. Increased efforts to expand health-care coverage or to provide colorectal cancer tests to people without health-care coverage are needed to increase colorectal cancer screening. (Cancer Epidemiol Biomarkers Prev 2008;17(7):1623–30)

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