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Complete Health Indicator Report of Colorectal Cancer Screening

Definition

The proportion of respondents ages 50-75 who reported having recommended colorectal cancer screening (sigmoidoscopy or colonoscopy in the past 10 years or having an FOBT [fecal occult blood test] in the last year).

Numerator

The number of respondents ages 50-75 reported having recommended colorectal cancer screening (sigmoidoscopy or colonoscopy in the past 10 years or having an FOBT [fecal occult blood test] in the last year).

Denominator

The total number of survey respondents aged 50-75 excluding those who answered "don't know" or "refused" to the numerator question.

Data Interpretation Issues

To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. In 2016 age distribution changed from 8 age groups to 5 age groups. This change in methodology may affect interpretation of data trends.

Why Is This Important?

Colorectal cancer is one of the leading causes of cancer-related deaths in the U.S. and Utah. Screening for this cancer is important as deaths can be substantially reduced when precancerous polyps are detected at early stages and removed. The chance of surviving colorectal cancer exceeds 90% when the cancer is diagnosed before it has extended beyond the intestinal wall ([http://www.cancer.org]). The U.S. Preventive Services Task Force recommends that routine screening for colorectal cancer begin at age 45 for adults at average risk. Persons at high risk may need to begin screening at a younger age. Routine screening can include either an annual fecal occult blood test (FOBT), a flexible sigmoidoscopy every five years, a colonoscopy every 10 years, or a double-contrast barium enema every 5 to 10 years.

Other Objectives

CSTE Chronic Disease Indicators Similar to HP2020 Objective C-16: Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines.

How Are We Doing?

Colorectal cancer screening rates in Utah have generally increased over the last decade, with a screening rate of 62.3% in 2010 increasing to a rate of 74.1% in 2020 among adults aged 50-74. Colorectal cancer screening rates across the state vary by geography and other sociodemographic factors. Among local health districts (LHDs) in 2020, San Juan LHD (42.7%), TriCounty LHD (50.1%), and Southeast Utah LHD (64.6%) had significantly lower colorectal cancer screening rates than the state average (74.3%). See additional data views for more specific differences between Utah Small Areas. In 2020, Hispanic adults aged 50-75 were significantly less likely (59.1%) than non-Hispanic adults (76.1%) to report having completed the recommended colorectal cancer screening. Those who racially identified as Asian (57.3%) or American Indian/Alaskan Native (53.1%) were also significantly less likely to report having completed the recommended colorectal cancer screening compared to all races (72.1%) for combined years 2016, 2018, and 2020. In 2020, those who reported having received less than a high school education were screened for colorectal cancer at significantly lower rates (53.4%) than others who had more education. Average colorectal cancer screening rates increased with each additional education level attained. Also in 2020, those who reported an annual household income of less than $25,000 were significantly less likely to report having completed a recommended colorectal cancer screening (63.2%) compared to those with higher incomes. Adults aged 65-75 were significantly more likely to report having received a recommended colorectal cancer screening (84.4%) than adults aged 50-64 (69.0%) based on 2020 BRFSS data. There was no significant difference in colorectal cancer screening rates between males and females.

How Do We Compare With the U.S.?

Nationally, the percentage of adults aged 50-74 completing recommended colorectal cancer screening was 73.9% in 2020, compared to the Utah screening rate of 74.1%. Current data appears to parallel previously seen trends, with Utah screening rates being comparable to the U.S. average.

What Is Being Done?

Screening for colorectal cancer has recently been identified by the Centers for Disease Control and Prevention (CDC) as a priority public health issue.

Available Services

Coverage of colorectal cancer screening tests is required by the Affordable Care Act (ACA). However, the ACA doesn't apply to health plans that were in place before it was passed (so-called grandfathered plans). You can find out your insurance plan's grandfathered status by contacting your health insurance company or your employer's human resources department. If your plan started on or after September 23, 2010, it is required to cover colonoscopies and other colorectal cancer screening tests. If a plan started before September 23, 2010, it may still have coverage requirements from state laws, which vary, and other federal laws.

Health Program Information

The mission of the Utah Cancer Coalition is to lower cancer incidence, morbidity, and mortality in Utah through collaborative efforts directed toward cancer prevention and control. As a result, they support community-based strategies around food security, healthy neighborhoods, access to healthcare, and financial toxicity in order to prevent cancer; detect cancer early; and improve the lives of cancer survivors, caregivers, and their families.


Related Indicators

Relevant Population Characteristics

The U.S. Preventive Services Task Force recommends that adults age 45 to 75 be screened for colorectal cancer.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Medicare will pay for an annual fecal occult blood test, a flexible sigmoidoscopy every four years, and a colonoscopy every ten years for persons with Medicare aged 50 or older who are at average risk for colorectal cancer. Medicare also covers surveillance of high risk patients (those with a personal history of colorectal cancer or adenomatous polyps or a history of colorectal cancer or adenomatous polyps in a first degree relative or those diagnosed with inflammatory bowel disease) with colonoscopy every two years.

Related Health Care System Factors Indicators:


Risk Factors

Colorectal cancer risk increases with age, inflammatory bowel disease, a personal or family history of colorectal cancer or polyps, and certain hereditary syndromes. A diet high in fat and low in fiber, lack of regular physical activity, obesity, excessive alcohol consumption, and smoking are also thought to increase risk. A diet high in fruits and vegetables, hormone replacement therapy in post-menopausal women, and aspirin use may reduce colorectal cancer risk.

Related Risk Factors Indicators:


Health Status Outcomes

When colorectal cancers are detected at an early, localized stage of disease, the 5-year survival rate is 90%. However, only 39% of colorectal cancers are discovered at that stage ([http://www.cancer.org]).

Related Health Status Outcomes Indicators:




Graphical Data Views

Recommended Colon Cancer Screening, Utah and U.S., 2010-2020

::chart - missing::
confidence limits

Please note: In May 2021, the U.S. Preventive Services Task Force changed its colorectal cancer screening recommendation. The age at which adults at average risk of getting colorectal cancer were recommended to begin screening was lowered from 50 to 45. The data shown here do not include adults younger than age 50.
BRFSS Utah vs. U.S.YearPercentage of Adults 50-75Lower LimitUpper LimitNote
Record Count: 13
UT New Methodology201066.3%63.8%68.6%*ages 50-74
UT New Methodology201270.7%68.4%72.9%*ages 50-74
UT New Methodology201380.3%77.7%82.7%*ages 50-74
UT New Methodology201472.5%70.2%74.6%*ages 50-74
UT New Methodology201673.7%71.3%76.0%*ages 50-74
UT New Methodology201870.6%68.0%73.1%*ages 50-74
UT New Methodology202075.6%73.2%77.9%*ages 50-74
US New Methodology201064.4%64.0%64.7%*ages 50-74
US New Methodology201265.2%64.8%65.6%*ages 50-74
US New Methodology201466.0%65.6%66.4%*ages 50-74
US New Methodology201667.4%67.0%67.8%*ages 50-74
US New Methodology201869.1%68.6%69.6%*ages 50-74
US New Methodology202073.9%73.4%74.5%*ages 50-74

Data Notes

^ ^*National BRFSS data is published in 5 year age groupings and query by age group 50-75 is not possible, therefore ages 50-74 is used instead. Utah data is also presented for adults ages 50-74 for better comparison to national rates. Due to changes in survey methodology and changes in U.S. Preventive Services Task Force guidelines, only data after 2010 is presented.

Data Sources

  • Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]
  • Behavioral Risk Factor Surveillance System Survey Data, US Department of Health and Human Services Centers for Disease Control and Prevention (CDC).


Recommended Colon Cancer Screening by Ethnicity, Utah, 2020

::chart - missing::
confidence limits

Hispanic EthnicityPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 3
Hispanic/Latino59.1%50.2%67.4%
Non-Hispanic/Latino76.1%74.3%77.8%
All ethnicities74.3%72.4%76.1%

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Recommended Colon Cancer Screening by Race, Utah, 2016, 2018, 2020 Combined Years

::chart - missing::
confidence limits

RacePercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 7
American Indian/Alaska Native53.1%43.3%62.6%
Asian57.3%45.0%68.7%
Black, African American71.8%58.1%82.5%
Native Hawaiian, Pacific Islander64.3%43.4%80.9%
White73.7%72.6%74.8%
Other57.1%50.7%63.2%
All races72.1%71.0%73.1%

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Recommended Colon Cancer Screening by Utah Small Area, 2016, 2018, and 2020

::chart - missing::
confidence limits

Utah Small AreasPercentage of Adults Ages 50-75Lower LimitUpper LimitNote
Record Count: 100
Brigham City76.2%64.4%85.0%
Box Elder Co (Other) V279.0%64.2%88.8%
Tremonton75.9%58.3%87.7%*
Logan V273.7%64.6%81.2%
North Logan81.0%67.9%89.6%
Cache (Other)/Rich (All) V279.1%69.8%86.1%
Hyrum84.4%64.9%94.1%*
Smithfield75.1%59.0%86.3%
Ben Lomond69.3%61.6%76.1%
Weber County (East)82.2%73.9%88.3%
Morgan County69.0%51.8%82.2%
Ogden (Downtown)69.9%59.4%78.6%
South Ogden71.2%62.1%78.9%
Roy/Hooper74.5%65.2%81.9%
Riverdale76.4%62.4%86.4%
Clearfield Area/Hooper73.8%64.4%81.4%
Layton/South Weber77.2%70.4%82.8%
Kaysville/Fruit Heights80.8%72.1%87.3%
Syracuse78.5%66.3%87.1%
Centerville78.0%65.0%87.2%
Farmington72.9%59.6%83.1%
North Salt Lake75.6%60.2%86.3%
Woods Cross/West Bountiful74.1%55.4%86.8%*
Bountiful80.9%73.2%86.7%
SLC (Rose Park)69.5%56.4%80.1%
SLC (Avenues)77.5%65.7%86.1%
SLC (Foothill/East Bench)76.3%64.2%85.3%
Magna56.4%42.9%68.9%
SLC (Glendale) V243.0%26.3%61.5%
West Valley (Center)68.6%57.4%78.1%
West Valley (West) V277.5%64.9%86.5%
West Valley (East) V260.4%48.1%71.4%
SLC (Downtown) V259.8%45.3%72.8%
SLC (Southeast Liberty)85.3%74.8%91.9%
South Salt Lake58.6%43.3%72.4%
SLC (Sugar House)72.1%58.6%82.5%
Millcreek (South)78.7%64.9%88.1%
Millcreek (East)86.9%77.4%92.8%
Holladay V275.2%63.2%84.2%
Cottonwood77.6%68.9%84.4%
Kearns V261.2%47.8%73.1%
Taylorsville (E)/Murray (W)77.0%66.0%85.2%
Taylorsville (West)75.5%65.1%83.6%
Murray82.6%71.9%89.8%
Midvale70.7%57.2%81.3%
West Jordan (Northeast) V277.6%64.8%86.7%
West Jordan (Southeast)74.9%62.9%84.0%
West Jordan (W)/Copperton75.2%60.6%85.7%
South Jordan V276.2%65.6%84.4%
Daybreak74.9%61.2%85.0%
Sandy (West)67.3%53.1%78.8%
Sandy (Center) V276.2%63.4%85.6%
Sandy (Northeast)73.4%62.2%82.2%
Sandy (Southeast)82.0%73.4%88.3%
Draper74.6%63.7%83.0%
Riverton/Bluffdale75.4%64.6%83.7%
Herriman73.3%59.1%84.0%
Tooele County (Other)64.1%53.6%73.3%
Tooele Valley71.3%64.7%77.1%
Eagle Mountain/Cedar Valley66.6%48.1%81.2%
Lehi69.8%59.8%78.3%
Saratoga Springs60.9%42.6%76.6%
American Fork76.8%66.8%84.5%
Alpine78.4%59.7%89.9%*
Pleasant Grove/Lindon70.6%62.2%77.8%
Orem (North)67.8%54.8%78.6%
Orem (West)87.6%75.4%94.2%*
Orem (East)85.5%75.2%91.9%
Provo/BYU75.6%63.3%84.8%
Provo (West City Center)53.8%40.8%66.3%
Provo (East City Center)80.9%61.0%92.0%*
Salem City67.2%45.0%83.7%*
Spanish Fork73.6%62.9%82.1%
Springville65.5%52.2%76.8%
Mapleton73.9%55.7%86.5%*
Utah County (South) V272.7%54.0%85.8%*
Payson63.7%51.9%74.0%
Park City79.9%70.3%87.0%
Summit County (East)77.1%68.5%84.0%
Wasatch County72.9%65.6%79.1%
Daggett and Uintah County53.2%45.6%60.7%
Duchesne County57.6%49.1%65.7%
Nephi/Mona71.2%55.4%83.2%
Delta/Fillmore59.4%45.5%71.8%
Sanpete Valley64.3%54.8%72.8%
Central (Other)66.9%60.2%73.0%
Richfield/Monroe/Salina65.1%55.0%74.0%
Carbon County64.6%57.7%70.9%
Emery County69.2%60.2%77.0%
Grand County63.7%51.2%74.5%
Blanding/Monticello53.7%40.9%66.0%
San Juan County (Other)41.5%24.4%60.8%
St. George75.0%68.6%80.4%
Washington Co (Other) V262.2%45.0%76.8%
Washington City73.0%61.4%82.2%
Hurricane/La Verkin65.0%52.8%75.6%
Ivins/Santa Clara75.3%60.4%85.9%
Cedar City61.8%51.6%71.1%
Southwest LHD (Other)66.7%57.3%75.0%
State of Utah72.1%71.0%73.1%

Data Notes

A description of the Utah Small Areas may be found on IBIS at the following URL: [http://ibis.health.utah.gov/pdf/resource/UtahSmallAreaInfo.pdf]. *Use caution in interpreting; the estimate has a coefficient of variation >30% and is therefore deemed unreliable by the Utah Department of Health and Human Services.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Recommended Colon Cancer Screening by Local Health District, 2020

::chart - missing::
confidence limits

Local Health DistrictPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 14
Bear River77.1%69.8%83.2%
Central67.3%59.0%74.6%
Davis County78.2%72.3%83.2%
Salt Lake County76.3%72.9%79.3%
San Juan42.7%25.2%62.3%
Southeast64.6%55.5%72.7%
Southwest70.0%63.0%76.2%
Summit78.4%66.3%87.0%
Tooele73.9%63.1%82.4%
TriCounty50.1%38.5%61.7%
Utah County74.8%70.0%79.1%
Wasatch75.9%64.5%84.5%
Weber-Morgan73.1%66.7%78.6%
State of Utah74.3%72.4%76.1%

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Recommended Colon Cancer Screening by Education, Utah, 2020

::chart - missing::
confidence limits

Education LevelPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 5
Less than high school53.4%43.2%63.4%
H.S. grad or G.E.D.72.0%67.9%75.7%
Some post high school74.8%71.7%77.6%
College graduate80.3%77.8%82.6%
Total74.3%72.4%76.1%

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Recommended Colon Cancer Screening by Income, Utah, 2020

::chart - missing::
confidence limits

Income CategoryPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 5
<$25,00063.2%57.1%68.8%
$25,000-$49,99971.5%66.5%76.0%
$50,000-$74,99976.2%71.4%80.4%
$75,000+78.7%76.1%81.1%
Total74.3%72.4%76.1%

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Recommended Colon Cancer Screening by Age and Sex, Utah, 2020

::chart - missing::
confidence limits

Males vs. FemalesAge GroupPercentage of Adults 50-75Lower LimitUpper Limit
Record Count: 6
Male50-6467.0%63.2%70.5%
Male65-7584.7%81.3%87.5%
Female50-6471.0%67.4%74.3%
Female65-7584.2%80.8%87.1%
Total50-6469.0%66.4%71.4%
Total65-7584.4%82.1%86.5%

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

References and Community Resources

Utah Breast & Cervical Cancer Screening Program: [https://cancer.utah.gov/][[br]] Utah Cancer Coalition: [https://utahcancercoalition.org/][[br]] American Cancer Society: [http://www.cancer.org][[br]] National Cancer Institute: [http://www.cancer.gov][[br]] Huntsman Cancer Institute: [https://healthcare.utah.edu/huntsmancancerinstitute/screening-prevention][[br]] Centers for Disease Control and Prevention: [http://www.cdc.gov][[br]] American Society of Clinical Oncology: [http://www.asco.org][[br]]

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

Page Content Updated On 03/26/2024, Published on 04/22/2024
The information provided above is from the Utah Department of Health's Center for Health Data IBIS-PH web site (http://epht.health.utah.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 25 May 2024 23:12:06 from Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://epht.health.utah.gov ".

Content updated: Mon, 22 Apr 2024 12:55:00 MDT