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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]).

Healthy People Objective C-16:

Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines
U.S. Target: 70.5 percent
State Target: 80 percent among adults aged 50-75

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 69.9% in 2018 among adults age 50-74. Colorectal cancer screening rates across the state vary by geography and other sociodemographic factors. Among local health districts (LHDs) in 2018, Central Utah and TriCounty LHDs had significantly lower colorectal cancer screening rates (61.2% and 57.0%, respectively) than the state average (70.0%). See additional data views for more specific differences between Utah Small Areas. In 2018, Hispanic adults aged 50-74 were significantly less likely (43.6%) than non-Hispanic adults (72.4%) to report having completed the recommended colorectal cancer screening. Those who racially identified as Asian (55.3%) or American Indian/Alaskan Native (49.7%) were also significantly less likely to report having completed the recommended colorectal cancer screening compared to all races (70.7%) for combined years 2014, 2016, and 2018. In 2018, those who reported having received less than a high school education were screened for colorectal cancer at significantly lower rates (49.8%) than others who had more education. Average colorectal cancer screening rates increased with each additional education level attained. Also in 2018, 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 (59.8%) compared to those with higher incomes. Adults aged 65-75 were significantly more likely to report having received a recommended colorectal cancer screening (80.7%) than adults aged 50-64 (64.4%) based on 2018 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 having recommended colorectal cancer screening was 69.1% in 2018, compared to the Utah screening rate of 69.9%. 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. 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

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, prostate, skin, breast, and colorectal cancers as well as the promotion of physical activity, healthy eating habits, and Cancer survivorship advocacy.


Related Indicators

Relevant Population Characteristics

Screening for colorectal cancer has been identified by the CDC and the U.S. Preventive Services Task Force as a priority issue for individuals 50 years of age or older.

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., 2010-2018

::chart - missing::
confidence limits

^ ^*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.
BRFSS Utah vs. U.S.YearPercentage of Adults *50-74Lower LimitUpper LimitNote
Record Count: 11
UT New Methodology201062.3%60.4%64.1%*ages 50-74
UT New Methodology201267.7%65.9%69.4%*ages 50-74
UT New Methodology201376.4%74.1%78.6%*ages 50-74
UT New Methodology201470.0%68.4%71.5%*ages 50-74
UT New Methodology201671.6%69.7%73.6%*ages 50-74
UT New Methodology201869.9%68.1%71.8%*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

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 Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
  • U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services


Recommended Colon Cancer Screening by Ethnicity, Utah, 2018

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confidence limits

Hispanic EthnicityPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 3
Hispanic43.6%35.8%51.8%
Non-Hispanic72.4%70.6%74.2%
All Utahns70.0%68.2%71.8%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Recommended Colon Cancer Screening by Race, Utah, 2014, 2016, 2018 Combined Years

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confidence limits

RacePercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 6
American Indian/Native Alaskan49.7%40.6%58.8%
Asian55.3%42.4%67.4%
Black67.8%54.3%78.9%
Pacific Islander62.3%41.8%79.2%
White72.5%71.5%73.5%
All Races70.7%69.7%71.7%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Recommended Colon Cancer Screening by Utah Small Area, 2014, 2016, and 2018

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confidence limits

Utah Small AreasPercentage of Adults Ages 50-75Lower LimitUpper LimitNote
Record Count: 100
Brigham City72.4%62.4%80.6%
Box Elder Co (Other) V282.1%67.7%90.9%*
Tremonton73.2%55.5%85.7%
Logan V272.4%63.4%80.0%
North Logan77.7%66.0%86.2%
Cache (Other)/Rich (All) V273.7%64.7%81.1%
Hyrum****
Smithfield76.1%60.0%87.1%
Ben Lomond67.2%59.7%73.9%
Weber County (East)80.0%71.7%86.3%
Morgan County****
Ogden (Downtown)67.2%57.5%75.6%
South Ogden75.1%66.6%82.1%
Roy/Hooper77.4%69.5%83.8%
Riverdale74.2%62.9%83.0%
Clearfield Area/Hooper72.6%64.7%79.4%
Layton/South Weber76.5%70.2%81.8%
Kaysville/Fruit Heights84.3%77.2%89.4%
Syracuse72.3%59.2%82.5%
Centerville83.7%73.3%90.6%
Farmington74.5%62.7%83.5%
North Salt Lake74.6%60.6%84.9%
Woods Cross/West Bountiful75.0%58.4%86.4%
Bountiful78.0%70.6%83.9%
SLC (Rose Park)66.5%53.3%77.6%
SLC (Avenues)76.1%65.3%84.4%
SLC (Foothill/East Bench)75.7%64.1%84.5%
Magna53.7%40.8%66.2%
SLC (Glendale) V255.8%39.3%71.0%
West Valley (Center)62.6%52.5%71.6%
West Valley (West) V267.9%55.4%78.2%
West Valley (East) V254.8%43.7%65.4%
SLC (Downtown) V258.0%45.6%69.5%
SLC (Southeast Liberty)81.0%70.7%88.3%
South Salt Lake57.8%44.1%70.4%
SLC (Sugar House)76.0%62.1%86.0%
Millcreek (South)83.2%73.3%90.0%
Millcreek (East)85.9%76.5%92.0%
Holladay V279.3%68.7%87.0%
Cottonwood77.2%69.4%83.4%
Kearns V261.8%49.6%72.6%
Taylorsville (E)/Murray (W)71.7%61.9%79.8%
Taylorsville (West)72.6%63.2%80.4%
Murray77.0%66.2%85.2%
Midvale66.4%54.3%76.7%
West Jordan (Northeast) V275.0%64.7%83.1%
West Jordan (Southeast)73.9%63.6%82.1%
West Jordan (W)/Copperton73.3%59.0%84.0%
South Jordan V280.0%71.3%86.6%
Daybreak****
Sandy (West)70.3%57.9%80.3%
Sandy (Center) V276.4%65.3%84.8%
Sandy (Northeast)74.4%64.8%82.1%
Sandy (Southeast)80.4%71.5%87.0%
Draper71.2%60.8%79.7%
Riverton/Bluffdale72.9%62.6%81.2%
Herriman71.4%57.4%82.1%
Tooele County (Other)63.7%53.7%72.6%
Tooele Valley68.5%61.7%74.7%
Eagle Mountain/Cedar Valley****
Lehi67.5%57.0%76.5%
Saratoga Springs****
American Fork77.9%69.8%84.3%
Alpine****
Pleasant Grove/Lindon65.8%57.3%73.4%
Orem (North)66.7%54.0%77.3%
Orem (West)83.9%73.3%90.8%
Orem (East)81.5%70.8%88.9%
Provo/BYU66.2%55.3%75.6%
Provo (West City Center)58.4%45.0%70.6%
Provo (East City Center)****
Salem City****
Spanish Fork66.9%56.0%76.2%
Springville68.2%55.7%78.4%
Mapleton****
Utah County (South) V2****
Payson58.8%46.5%70.0%
Park City79.1%71.4%85.1%
Summit County (East)72.8%65.4%79.1%
Wasatch County70.6%64.0%76.4%
Daggett and Uintah County53.5%47.2%59.6%
Duchesne County63.3%55.6%70.3%
Nephi/Mona77.4%64.0%86.8%
Delta/Fillmore62.6%52.6%71.7%
Sanpete Valley64.2%54.2%73.0%
Central (Other)67.3%60.5%73.4%
Richfield/Monroe/Salina65.0%54.8%74.0%
Carbon County68.1%61.2%74.2%
Emery County71.8%63.3%78.9%
Grand County56.8%44.8%68.2%
Blanding/Monticello41.8%28.6%56.2%
San Juan County (Other)35.8%18.7%57.5%
St. George71.1%65.1%76.5%
Washington Co (Other) V271.7%54.9%84.0%
Washington City70.9%59.3%80.4%
Hurricane/La Verkin65.6%54.0%75.6%
Ivins/Santa Clara76.0%62.2%85.9%
Cedar City62.1%52.4%70.9%
Southwest LHD (Other)69.0%60.3%76.4%
State of Utah70.7%69.7%71.7%

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 Utah Department of Health standards. **The estimate has been suppressed because 1) the relative standard error is greater than 50% or 2) the observed number of events is very small and not appropriate for publication.

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Recommended Colon Cancer Screening by Local Health District, 2018

::chart - missing::
confidence limits

Local Health DistrictPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 14
Bear River76.5%69.1%82.6%
Central61.2%53.2%68.2%
Davis County74.9%69.1%80.0%
Salt Lake County71.2%67.9%74.3%
San Juan51.9%33.0%70.2%
Southeast69.8%61.4%77.0%
Southwest65.3%58.9%71.2%
Summit74.9%63.2%83.8%
Tooele69.7%60.4%77.6%
TriCounty57.0%48.7%64.8%
Utah County66.9%61.9%71.5%
Wasatch72.7%60.6%82.3%
Weber-Morgan74.7%68.5%80.0%
State of Utah70.0%68.2%71.8%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Recommended Colon Cancer Screening by Education, Utah, 2018

::chart - missing::
confidence limits

Education LevelPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 5
Less Than High School49.8%40.3%59.4%
H.S. Grad or G.E.D.66.7%62.8%70.4%
Some Post High School72.0%68.9%75.0%
College Graduate74.3%71.5%76.9%
Total70.0%68.2%71.8%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Recommended Colon Cancer Screening by Income, Utah, 2018

::chart - missing::
confidence limits

Income CategoryPercentage of Adults Ages 50-75Lower LimitUpper Limit
Record Count: 5
<$25,00059.8%54.0%65.4%
$25,000-$49,99965.3%60.5%69.8%
$50,000-$74,99974.8%70.2%78.8%
$75,000+74.6%71.8%77.2%
Total70.0%68.2%71.8%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health


Recommended Colon Cancer Screening by Age and Sex, Utah, 2018

::chart - missing::
confidence limits

Males vs. FemalesAge GroupPercentage of Adults 50-75Lower LimitUpper Limit
Record Count: 6
Male50-6462.7%59.1%66.2%
Male65-7581.0%77.4%84.1%
Female50-6466.1%62.7%69.4%
Female65-7580.4%76.8%83.5%
Total50-6464.4%61.9%66.8%
Total65-7580.7%78.2%83.0%

Data Source

Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health

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][[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 10/29/2019, Published on 11/04/2019
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 Fri, 15 November 2019 13:24:50 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Mon, 4 Nov 2019 16:13:55 MST