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Complete Health Indicator Report of Colorectal Cancer Deaths

Definition

The rate of death from cancer of the colon or rectum (ICD-10: C18-C21) per 100,000 persons.

Numerator

The number of deaths due to colorectal cancer for a given time period (ICD-10: C18-C21).

Denominator

The population in Utah or the U.S. for a given time period.

Why Is This Important?

Colorectal cancer is the second leading cause of cancer-related deaths in Utah and the U.S. When national cancer-related deaths are estimated separately for males and females, colorectal cancer is the third leading cause of cancer death behind lung and breast cancer for females and behind lung and prostate cancer for males. Deaths from colorectal cancer can be substantially reduced when precancerous polyps are detected early and removed. When colorectal cancer is diagnosed early, 90% of patients survive at least five years^1^. Several scientific organizations recommend that routine screening for colorectal cancer begin at age 50 for adults at average risk. Persons at high risk may need to begin screening at a younger age. Routine screening can include either annual fecal occult blood test (FOBT), and/or flexible sigmoidoscopy every five years or colonoscopy every 10 years or double-contrast barium enema every 5 to 10 years. Studies have shown that FOBT testing, when performed every 1 to 2 years in people aged 50 to 80 years, can help reduce the number of deaths due to colorectal cancer by 15 to 33 percent^2,3^. The National Cancer Institute advises each individual to discuss risk factors and screening options with his or her health care provider. Medicare and many insurance plans now help to pay for colorectal cancer screening.[[br]] [[br]] ---- 1. American Cancer Society, Colorectal Cancer Facts & Figures 2014-2016 Accesed at: [http://www.cancer.org/acs/groups/content/documents/document/acspc-042280.pdf].[[br]] 2. Burch JA, Soares-Weiser K, St John DJ, et al. Diagnostic accuracy of fecal occult blood tests used in screening for colorectal cancer: A systematic review. ''Journal of Medical Screening'' 2007; 14(3):132-137.[[br]] 3. Ouyang DL, Chen JJ, Getzenberg RH, Schoen RE. Noninvasive testing for colorectal cancer: A review. ''American Journal of Gastroenterology'' 2005; 100(6):1393-1403.

Healthy People Objective C-5:

Reduce the colorectal cancer death rate
U.S. Target: 14.5 deaths per 100,000 population

How Are We Doing?

Utah's colorectal cancer mortality rate has decreased steadily over the past several decades. The colorectal cancer mortality rate ranged from 20.1 per 100,000 population in 1980 to 11.5 per 100,000 population in 2015. Colorectal cancer mortality rates increase with age. Utah women aged 55 to 64 had significantly lower mortality rates than Utah men in this age group (11.1 per 100,000 women compared to 23.8 per 100,000 men for years 2013-2015 combined). Among health districts, between 2011 and 2015 the age-adjusted colorectal cancer mortality rate ranged from a high of 17.2 per 100,000 population in TriCounty Health District to rates below 9 per 100,000 population in Wasatch, Tooele, and Summit Health Districts. Looking at Utah Small Areas between 2011 and 2015, compared to the state rate, Logan and *Sandy (SE) were the only small areas to have a significantly lower colorectal cancer mortality rate (6.6 per 100,000 population in Logan and 3.2 per 100,000 in Sandy (SE); *note: Sandy (SE) rate does not meet UDOH data reliability standards and should be interpreted with caution). Meanwhile, TriCounty and South Salt Lake were the only small areas to have significantly higher rates (17.2 per 100,000 population in TriCounty and 22.2 per 100,000 population in South Salt Lake).

How Do We Compare With the U.S.?

The Utah age-adjusted colorectal cancer mortality rate has been consistently lower than the rate for the U.S. For example, in 2015, Utah's colorectal cancer mortality rate was 11.5 per 100,000 population compared with the U.S. rate of 14.2 per 100,000 population.

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. The the Utah Cancer Control Program (UCCP) monitors the use of colorectal cancer screening tests by Utahns through the statewide Behavioral Risk Factor Surveillance System (BRFSS), which is conducted annually.

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

In June 2002, the Utah Cancer Control Program (UCCP) received a grant from the CDC to launch a statewide education campaign. From 2009-2015, the UCCP received a CDC grant to begin offering colorectal cancer screenings to low-income and uninsured Utahns. In addition to the screening program, monies were used for educational and promotional activities. Education efforts serve to increase awareness about colorectal cancer and promote screening and early detection for Utahns aged 50 and older. In addition, the Utah Department of Health initiated the Utah Cancer Action Network (UCAN), a statewide partnership whose goal is to reduce the burden of cancer. The mission of the UCAN is to lower cancer incidence and mortality in Utah through collaborative efforts directed toward cancer prevention and control. As a result of this planning process, objectives and strategies have been developed by community partners regarding the early detection of cervical, breast, and colorectal cancers as well as the promotion of physical activity, healthy eating habits, melanoma cancer prevention, and cancer survivorship advocacy.


Related Indicators

Relevant Population Characteristics

The risk of developing colorectal cancer increases with age. Lack of physical activity also contributes to a person's risk of developing colorectal cancer. Smoking, a low fiber and high-fat diet, low fruit and vegetable intake, excessive alcohol use, and obesity may also increase risk.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Medicare will pay for an annual fecal occult blood test (FOBT), a flexible sigmoidoscopy every four years, and a colonoscopy every 10 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

Risk factors for colorectal cancer include increasing age, inflammatory bowel disease, a family history of polyps or colorectal cancer, a personal history of polyps or colorectal cancer, and certain hereditary syndromes. Physical inactivity, a low fiber/high fat diet, obesity, excessive alcohol consumption, and tobacco use may all 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:




Graphical Data Views

Colorectal Cancer Deaths by Year, Utah and U.S., 1999-2015

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confidence limits

Utah vs. U.S.YearAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 34
Utah199916.414.418.6
Utah200017.815.820.0
Utah200113.611.915.6
Utah200215.413.517.4
Utah200314.512.716.4
Utah200412.510.814.3
Utah200513.411.815.3
Utah200613.011.414.8
Utah200712.511.014.2
Utah200811.49.913.0
Utah200912.711.214.4
Utah201011.910.413.4
Utah201111.610.213.2
Utah201210.69.212.0
Utah201310.99.612.4
Utah201411.810.413.3
Utah201511.510.213.0
U.S.199920.920.821.1
U.S.200020.820.620.9
U.S.200120.220.020.4
U.S.200219.819.620.0
U.S.200319.219.019.4
U.S.200418.218.018.3
U.S.200517.717.517.8
U.S.200617.417.317.6
U.S.200717.016.917.2
U.S.200816.616.516.8
U.S.200916.015.916.1
U.S.201015.815.715.9
U.S.201115.315.215.4
U.S.201214.914.815.0
U.S.201314.614.514.7
U.S.201414.314.214.4
U.S.201514.214.114.3

Data Notes

ICD-10 codes used to define colorectal cancer: C18-C21. Age-adjusted to U.S. 2000 standard population.

Data Sources

  • U.S. Underlying Cause of Death Data: WONDER Online Database. Centers for Disease Control and Prevention, National Center for Health Statistics. Accessed at [http://wonder.cdc.gov/ucd-icd10.html]
  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2015
  • National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention


Colorectal Cancer Deaths by Age and Sex, Utah, 2013-2015

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confidence limits

Males vs. FemalesAge GroupDeaths per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 12
Male0-340.40.20.7*
Male35-443.21.95.0
Male45-5410.47.613.7
Male55-6423.819.329.0
Male65-7430.323.837.9
Male75+115.399.3133.1
Female0-340.30.10.6*
Female35-442.81.64.6
Female45-547.65.310.6
Female55-6411.18.214.8
Female65-7431.925.539.4
Female75+89.276.8103.1

Data Notes

Codes used to define colorectal cancer: ICD-10 C18-21. [[br]] *Use caution in interpreting rates for Males and Females 0-34. The estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2015


Colorectal Cancer Deaths by Local Health District, Utah, 2011-2015

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confidence limits

Local Health DistrictAge-adjusted Death Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 14
Bear River9.97.712.6
Central9.06.312.5
Davis County10.08.211.9
Salt Lake County12.111.113.2
San Juan10.54.221.8*, ^
Southeast15.010.420.9^
Southwest10.99.113.0
Summit8.94.615.6
Tooele8.35.112.8
TriCounty17.212.223.6
Utah County10.59.012.3
Wasatch8.03.515.7*
Weber-Morgan12.210.214.4
State of Utah11.310.711.9

Data Notes

Codes used to define colorectal cancer: ICD-10 C18-21.[[br]] Age-adjusted to U.S. 2000 standard population.[[br]] ^ ^*Use caution in interpreting, the estimate has a relative standard error greater than 30% and does not meet UDOH standards for reliability. For more information, please go to [http://ibis.health.utah.gov/pdf/resource/DataSuppression.pdf].[[br]] ^ ^^Prior to 2015 San Juan County was part of the Southeast Local Health District. In 2015 the San Juan County Local Health District was formed. Data reported are for all years using the current boundaries.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2015


Colorectal Cancer Deaths by Utah Small Area, 2011-2015

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confidence limits

Utah Small AreasAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 67
Brigham City14.48.423.1
Box Elder Co (Other)14.28.222.8
Logan6.63.810.6
Cache Co (Oth)/Rich Co (All)9.55.215.8
Ben Lomond11.87.917.1
Morgan Co (All)/Weber Co (E)10.16.115.7
Ogden (Downtown)17.911.626.5
South Ogden15.210.022.0
Roy/Hooper12.37.718.8
Riverdale9.14.516.4*
Clearfield/Hill AFB10.66.316.8
Layton8.75.613.1
Syracuse/Kaysville8.54.814.1
Farmington/Centerville8.54.315.1
Woods Cross/North Salt Lake12.56.621.6
Bountiful10.97.415.4
SLC (Rose Park)11.66.219.8
SLC (Avenues)12.36.820.5
SLC (Foothill/U of U)8.84.316.1*
Magna10.54.122.1*
SLC (Glendale)17.09.727.6
West Valley (West)14.49.720.8
West Valley (East)15.35.264.6* ^2011 only
West Valley (East) V212.77.320.5^2012-2015
SLC (Downtown)13.18.818.9
South Salt Lake22.213.933.6
Millcreek10.16.914.3
Holladay14.510.519.5
Cottonwood9.76.214.4
Kearns8.32.122.2* ^2011 only
Kearns V221.212.034.6^2012-2015
Taylorsville (E)/Murray (W)17.111.125.1
Taylorsville (West)10.25.218.0^2012-2015
Murray11.26.717.5
Midvale12.06.719.8
West Jordan (NE)35.813.875.4* ^2011 only
West Jordan (NE) V210.94.621.6* ^2012-2014
West Jordan (SE)12.96.822.2
West Jordan (W)/Copperton22.99.845.4*
South Jordan7.23.912.1
Sandy (Center)13.18.718.9
Sandy (NE)12.86.522.6
Sandy (SE)3.20.89.0*
Riverton/Draper11.07.216.1
Tooele Co8.55.213.1
Lehi/Cedar Valley11.36.717.8
American Fork/Alpine10.05.915.7
Pleasant Grove/Lindon13.58.320.7
Orem (North)11.86.420.0
Orem (West)9.64.817.3*
Orem (East)6.82.714.1*
Provo (North)/BYU12.27.219.3
Provo (South)14.07.623.4
Springville/Spanish Fork9.66.214.3
Utah Co (South)10.05.217.2
Summit Co9.44.716.7
Wasatch Co8.03.615.5*
TriCounty LHD17.212.223.6
Juab/Millard/Sanpete Co10.26.515.1
Sevier/Piute/Wayne Co8.04.114.1
Carbon/Emery Co14.69.421.7
Grand/San Juan Co13.77.922.1
St George8.66.211.7
Washington Co (Other)10.57.314.6
Cedar City15.910.123.8
Southwest LHD (Other)16.810.625.3
State11.510.912.2

Data Notes

Age-adjusted to the U.S. 2000 standard population. *Use caution in interpreting, the estimate has a relative standard error greater than 30% and does not meet UDOH standards for reliability. For more information, please go to [http://ibis.health.utah.gov/pdf/resource/DataSuppression.pdf] ^Due to Utah Small Area reclassification, these numbers only include data for certain years. A description of the Utah Small Areas may be found on IBIS at the following URL: [http://ibis.health.utah.gov/resource/Help.html].

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population estimates produced by the UDOH Center for Health Data and Informatics. Linear interpolation of U.S. Census Bureau and ESRI ZIP Code data provided annual population estimates for ZIP Code areas by sex and age groups, IBIS Version 2015


Colorectal Cancer Deaths by Ethnicity, Utah, 2013-2015

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confidence limits

Hispanic EthnicityAge-adjusted Rate per 100,000 PopulationLower LimitUpper Limit
Record Count: 3
Hispanic8.66.011.9
Non-Hispanic11.210.412.0
All Utahns11.010.311.8

Data Notes

Codes used to define colorectal cancer: ICD-10 C18-21.[[br]] Age-adjusted to U.S. 2000 standard population.

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates by Age, Sex, Race, and Hispanic Origin for Counties in Utah, U.S. Bureau of the Census, IBIS Version 2015


Colorectal Cancer Deaths by Race, Utah, 2013-2015

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confidence limits

RaceAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNote
Record Count: 6
American Indian/Native Alaskan13.15.825.5*
Asian9.55.016.4
Black29.916.150.6
Pacific Islander16.36.134.9*
White10.810.011.6
All Races11.010.311.8

Data Notes

Codes used to define colorectal cancer: ICD-10 C18-21.[[br]] Rates are age-adjusted to the 2000 U.S. standard population using 3 age groups (0-44, 45-64, and 65+). *Use caution in interpreting, the estimate has a relative standard error greater than 30% and does not meet UDOH standards for reliability. For more information, please go to [http://ibis.health.utah.gov/pdf/resource/DataSuppression.pdf].

Data Sources

  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates by Age, Sex, Race, and Hispanic Origin for Counties in Utah, U.S. Bureau of the Census, IBIS Version 2015

References and Community Resources

Utah Cancer Control Program: [http://www.cancerutah.org][[br]] Utah Cancer Action Network: [http://www.ucan.cc][[br]] American Cancer Society: [http://www.cancer.org][[br]] National Cancer Institute: [http://www.cancer.gov][[br]] Huntsman Cancer Institute: [http://www.huntsmancancer.org][[br]] Centers for Disease Control and Prevention: [http://www.cdc.gov][[br]] American Society of Clinical Oncology: [http://www.asco.org]

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.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 05/22/2017, Published on 05/26/2017
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 15 July 2018 15:05:43 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Fri, 26 May 2017 10:19:44 MDT