DefinitionThe rate of death from cancer of the colon or rectum (ICD-10: C18-C21) per 100,000 persons.
NumeratorThe number of deaths due to colorectal cancer for a given time period (ICD-10: C18-C21).
DenominatorThe 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]]
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.
Health Program InformationIn 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.