Colorectal Cancer is a Major Public Health Problem

Colorectal cancer is the second leading cause of cancer death in the U.S. when men and women are combined,¹ but it doesn’t have to be. Few preventive interventions are as reliably effective in reducing avoidable death as screening for colorectal cancer.

Colorectal Cancer Screening Rates

We’re tracking all major measures to assess our progress in reaching the goal of 80% of adults ages 50 or older screened for colorectal cancer. There are strengths and limitations of each.

NATIONAL SCREENING RATE – BRFSS

Percentage of U.S. Adults Age 50-75 years Up-to-Date with CRC Screening, Behavioral Risk Factor Surveillance System⁴

The increase in the screening rate between 2012 and 2018 represents an additional 9.3 million adults screened for colorectal cancer.⁴

NATIONAL SCREENING RATE – NHIS

CRC Screening Among Adults Aged 50-75 Years, US, 2013-2018, National Health Interview Survey⁵

The prevalence of up‐to‐date screening with any recommended test among individuals aged 50 years and older increased from 38% in 2000 to 66% in 2018. The lower screening rate in individuals younger than 65 years largely reflects a lag in uptake in those 50 to 54 years, among whom screening prevalence in 2018 was 48% versus 68% in those aged 55 to 64 years.

COMMUNITY HEALTH CENTER PATIENTS – UDS

Percentage of Federally Qualified Health Center Patients ages 50-75 years Up-to-Date with CRC Screening, Uniform Data System⁶

The UDS CRC screening rate was 41.9% in 2021, which amounts to 2,680,583 patients patients screened in 2021 alone.

INSURED ADULTS – HEDIS

Percentage of U.S. Adults Age 50-75 years Up-to-Date with CRC Screening, Healthcare Effectiveness Data and Information Set⁷

Screening rate data for Medicare plans is not available for 2019 because in March 2020 the Centers for Medicare & Medicaid Services (CMS) suspended Medicare quality reporting requirements in response to COVID-19. Visit the 80% Hall of Fame to see the list of health plans that have achieved 80%.

State and Local Level Screening Rates

The following sources provide state, county, and city level screening rates:

• Colorectal Cancer Facts & Figures, 2020-2022 (ACS) – state level screening, incidence, and mortality rates
• Colorectal Cancer Screening State Profiles (CDC) – state level screening rates by race/ethnicity, sex, insurance status, and age group
• United States Cancer Statistics: Data Visualizations (CDC)
  • CRC Screening – state and county-level estimates
  • CRC Incidence and Mortality – state and county-level estimates
  • CRC Incidence and Mortality Trends – state-level trends
• Cancer Statistics Center (ACS) – state-level screening, incidence, and mortality rates
• State Cancer Profiles (NCI) – county-level screening, incidence, and mortality rates
• 500 Cities Project (CDC) – screening rate estimates for 500 major U.S. cities

What Systems Have Reached 80%?

Top health systems already are achieving 80% screening rates. Massachusetts is already screening over 76% of their eligible population, the highest screening rate among US states. An 80% screening rate is achievable. Find more information about top-performing organizations on the 80% Hall of Fame. 

Colorectal Cancer Incidence & Mortality

Colorectal cancer incidence and mortality rates have dropped by over 30% in the U.S. among adults 50 and older in the last fifteen years, with a substantial fraction of these declines due to screening.

State and Local Level Incidence and Mortality Rates

The following sources provide state, county, and city level incidence and mortality rates:

• Colorectal Cancer Facts & Figures, 2017-2019 (ACS) – state level screening, incidence, and mortality rates
• Cancer Statistics Center (ACS) – state level screening, incidence, and mortality rates
• United States Cancer Statistics: Data Visualizations (CDC) – state and national incidence and mortality data and maps
• State Cancer Profiles (NCI) – county level screening, incidence, and mortality rates
• Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014 – county level mortality data and maps

Colorectal Cancer Disparities & Trends

Significant disparities in colorectal cancer screening, incidence, and mortality persist by socioeconomic status, race/ethnicity, geography, and other factors. In addition, recent research indicates colorectal cancer incidence rates are rising in young and middle-aged adults. Visit the following NCCRT News stories and other sources to learn more.

• Colorectal Cancer Facts & Figures, 2017-2019 (ACS)
• 2019 Colorectal Cancer Screening Messaging Guidebook (guidance on reaching priority populations) and corresponding Companion Guides for Hispanics/Latinos and Asian Americans
• JNCI study finds colorectal cancer rates risen dramatically in Gen X and Millennials
• Study identifies geographic hot spots for colorectal cancer mortality
• Inequalities in Premature Death From Colorectal Cancer by State

Visit the Resource Center to explore resources that address these and other disparities.

Sources

1. Cancer Facts & Figures. American Cancer Society. 2023. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2023-cancer-facts-figures.html
2. Colorectal Cancer Facts & Figures. American Cancer Society. 2020-2022. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2017-2019.pdf
3. Meester RG, Doubeni CA, Zauber AG, et al. Public Health Impact of Achieving 80% Colorectal Cancer Screening Rates in the United States by 2018. Cancer. 2015 Jul 1;121(13):2281-5.
4. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, [2012, 2014, 2016, 2018, 2020].
5. Siegel RL, Miller KD, Sauer AG, et al. Colorectal cancer statistics, 2020. CA: A Cancer Journal for Clinicians. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21601
6. 2021 Health Center Data. Health Resources & Services Administration. 2021. https://bphc.hrsa.gov/uds/datacenter.aspx 
7. Colorectal Cancer Screening. National Committee for Quality Assurance. http://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality/2017-table-of-contents/colorectal-cancerents/colorectal-cancer 
8. Centers for Disease Control and Prevention (CDC). Quick Facts: Colorectal Cancer Screening in U.S. https://www.cdc.gov/cancer/colorectal/pdf/QuickFacts-BRFSS-2016-CRC-Screening-508.pdf
9. Centers for Disease Control and Prevention (CDC). Use of Colorectal Cancer Screening Tests. https://www.cdc.gov/cancer/colorectal/statistics/use-screening-tests-BRFSS.htm  
10. Centers for Disease Control and Prevention (CDC). National Health Interview Survey, 2015. Public use data file.
    https://www.cdc.gov/nchs/nhis/nhis_2015_data_release.htm