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 guidelinesU.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 50-75 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
^ ^*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. | Year | Percentage of Adults *50-74 | Lower Limit | Upper Limit | Note | |
---|---|---|---|---|---|---|
Record Count: 11 | ||||||
UT New Methodology | 2010 | 62.3% | 60.4% | 64.1% | *ages 50-74 | |
UT New Methodology | 2012 | 67.7% | 65.9% | 69.4% | *ages 50-74 | |
UT New Methodology | 2013 | 76.4% | 74.1% | 78.6% | *ages 50-74 | |
UT New Methodology | 2014 | 70.0% | 68.4% | 71.5% | *ages 50-74 | |
UT New Methodology | 2016 | 71.6% | 69.7% | 73.6% | *ages 50-74 | |
UT New Methodology | 2018 | 69.9% | 68.1% | 71.8% | *ages 50-74 | |
US New Methodology | 2010 | 64.4% | 64.0% | 64.7% | *ages 50-74 | |
US New Methodology | 2012 | 65.2% | 64.8% | 65.6% | *ages 50-74 | |
US New Methodology | 2014 | 66.0% | 65.6% | 66.4% | *ages 50-74 | |
US New Methodology | 2016 | 67.4% | 67.0% | 67.8% | *ages 50-74 | |
US New Methodology | 2018 | 69.1% | 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
Hispanic Ethnicity | Percentage of Adults Ages 50-75 | Lower Limit | Upper Limit | |||
---|---|---|---|---|---|---|
Record Count: 3 | ||||||
Hispanic | 43.6% | 35.8% | 51.8% | |||
Non-Hispanic | 72.4% | 70.6% | 74.2% | |||
All Utahns | 70.0% | 68.2% | 71.8% |
Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthRace | Percentage of Adults Ages 50-75 | Lower Limit | Upper Limit | |||
---|---|---|---|---|---|---|
Record Count: 7 | ||||||
American Indian/Native Alaskan | 49.7% | 40.6% | 58.8% | |||
Asian | 55.3% | 42.4% | 67.4% | |||
Black | 67.8% | 54.3% | 78.9% | |||
Pacific Islander | 62.3% | 41.8% | 79.2% | |||
White | 72.5% | 71.5% | 73.5% | |||
Two or More Races | 50.3% | 44.2% | 56.3% | |||
All Races | 70.7% | 69.7% | 71.7% |
Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthUtah Small Areas | Percentage of Adults Ages 50-75 | Lower Limit | Upper Limit | Note | ||
---|---|---|---|---|---|---|
Record Count: 100 | ||||||
Brigham City | 72.4% | 62.4% | 80.6% | |||
Box Elder Co (Other) V2 | 82.1% | 67.7% | 90.9% | * | ||
Tremonton | 73.2% | 55.5% | 85.7% | |||
Logan V2 | 72.4% | 63.4% | 80.0% | |||
North Logan | 77.7% | 66.0% | 86.2% | |||
Cache (Other)/Rich (All) V2 | 73.7% | 64.7% | 81.1% | |||
Hyrum | 62.8% | 43.5% | 78.7% | |||
Smithfield | 76.1% | 60.0% | 87.1% | |||
Ben Lomond | 67.2% | 59.7% | 73.9% | |||
Weber County (East) | 80.0% | 71.7% | 86.3% | |||
Morgan County | 71.5% | 56.1% | 83.1% | |||
Ogden (Downtown) | 67.2% | 57.5% | 75.6% | |||
South Ogden | 75.1% | 66.6% | 82.1% | |||
Roy/Hooper | 77.4% | 69.5% | 83.8% | |||
Riverdale | 74.2% | 62.9% | 83.0% | |||
Clearfield Area/Hooper | 72.6% | 64.7% | 79.4% | |||
Layton/South Weber | 76.5% | 70.2% | 81.8% | |||
Kaysville/Fruit Heights | 84.3% | 77.2% | 89.4% | |||
Syracuse | 72.3% | 59.2% | 82.5% | |||
Centerville | 83.7% | 73.3% | 90.6% | |||
Farmington | 74.5% | 62.7% | 83.5% | |||
North Salt Lake | 74.6% | 60.6% | 84.9% | |||
Woods Cross/West Bountiful | 75.0% | 58.4% | 86.4% | |||
Bountiful | 78.0% | 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% | |||
Magna | 53.7% | 40.8% | 66.2% | |||
SLC (Glendale) V2 | 55.8% | 39.3% | 71.0% | |||
West Valley (Center) | 62.6% | 52.5% | 71.6% | |||
West Valley (West) V2 | 67.9% | 55.4% | 78.2% | |||
West Valley (East) V2 | 54.8% | 43.7% | 65.4% | |||
SLC (Downtown) V2 | 58.0% | 45.6% | 69.5% | |||
SLC (Southeast Liberty) | 81.0% | 70.7% | 88.3% | |||
South Salt Lake | 57.8% | 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 V2 | 79.3% | 68.7% | 87.0% | |||
Cottonwood | 77.2% | 69.4% | 83.4% | |||
Kearns V2 | 61.8% | 49.6% | 72.6% | |||
Taylorsville (E)/Murray (W) | 71.7% | 61.9% | 79.8% | |||
Taylorsville (West) | 72.6% | 63.2% | 80.4% | |||
Murray | 77.0% | 66.2% | 85.2% | |||
Midvale | 66.4% | 54.3% | 76.7% | |||
West Jordan (Northeast) V2 | 75.0% | 64.7% | 83.1% | |||
West Jordan (Southeast) | 73.9% | 63.6% | 82.1% | |||
West Jordan (W)/Copperton | 73.3% | 59.0% | 84.0% | |||
South Jordan V2 | 80.0% | 71.3% | 86.6% | |||
Daybreak | 71.7% | 53.2% | 85.0% | |||
Sandy (West) | 70.3% | 57.9% | 80.3% | |||
Sandy (Center) V2 | 76.4% | 65.3% | 84.8% | |||
Sandy (Northeast) | 74.4% | 64.8% | 82.1% | |||
Sandy (Southeast) | 80.4% | 71.5% | 87.0% | |||
Draper | 71.2% | 60.8% | 79.7% | |||
Riverton/Bluffdale | 72.9% | 62.6% | 81.2% | |||
Herriman | 71.4% | 57.4% | 82.1% | |||
Tooele County (Other) | 63.7% | 53.7% | 72.6% | |||
Tooele Valley | 68.5% | 61.7% | 74.7% | |||
Eagle Mountain/Cedar Valley | 64.7% | 44.4% | 80.7% | |||
Lehi | 67.5% | 57.0% | 76.5% | |||
Saratoga Springs | 67.0% | 43.4% | 84.4% | * | ||
American Fork | 77.9% | 69.8% | 84.3% | |||
Alpine | 83.9% | 66.8% | 93.2% | * | ||
Pleasant Grove/Lindon | 65.8% | 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/BYU | 66.2% | 55.3% | 75.6% | |||
Provo (West City Center) | 58.4% | 45.0% | 70.6% | |||
Provo (East City Center) | 67.6% | 42.9% | 85.3% | * | ||
Salem City | 63.8% | 45.0% | 79.1% | |||
Spanish Fork | 66.9% | 56.0% | 76.2% | |||
Springville | 68.2% | 55.7% | 78.4% | |||
Mapleton | 77.0% | 58.8% | 88.7% | * | ||
Utah County (South) V2 | 63.8% | 44.2% | 79.7% | |||
Payson | 58.8% | 46.5% | 70.0% | |||
Park City | 79.1% | 71.4% | 85.1% | |||
Summit County (East) | 72.8% | 65.4% | 79.1% | |||
Wasatch County | 70.6% | 64.0% | 76.4% | |||
Daggett and Uintah County | 53.5% | 47.2% | 59.6% | |||
Duchesne County | 63.3% | 55.6% | 70.3% | |||
Nephi/Mona | 77.4% | 64.0% | 86.8% | |||
Delta/Fillmore | 62.6% | 52.6% | 71.7% | |||
Sanpete Valley | 64.2% | 54.2% | 73.0% | |||
Central (Other) | 67.3% | 60.5% | 73.4% | |||
Richfield/Monroe/Salina | 65.0% | 54.8% | 74.0% | |||
Carbon County | 68.1% | 61.2% | 74.2% | |||
Emery County | 71.8% | 63.3% | 78.9% | |||
Grand County | 56.8% | 44.8% | 68.2% | |||
Blanding/Monticello | 41.8% | 28.6% | 56.2% | |||
San Juan County (Other) | 35.8% | 18.7% | 57.5% | |||
St. George | 71.1% | 65.1% | 76.5% | |||
Washington Co (Other) V2 | 71.7% | 54.9% | 84.0% | |||
Washington City | 70.9% | 59.3% | 80.4% | |||
Hurricane/La Verkin | 65.6% | 54.0% | 75.6% | |||
Ivins/Santa Clara | 76.0% | 62.2% | 85.9% | |||
Cedar City | 62.1% | 52.4% | 70.9% | |||
Southwest LHD (Other) | 69.0% | 60.3% | 76.4% | |||
State of Utah | 70.7% | 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. For more information, please go to [http://ibis.health.utah.gov/pdf/resource/DataSuppression.pdf].[[br]]Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthLocal Health District | Percentage of Adults Ages 50-75 | Lower Limit | Upper Limit | |||
---|---|---|---|---|---|---|
Record Count: 14 | ||||||
Bear River | 76.5% | 69.1% | 82.6% | |||
Central | 61.2% | 53.2% | 68.2% | |||
Davis County | 74.9% | 69.1% | 80.0% | |||
Salt Lake County | 71.2% | 67.9% | 74.3% | |||
San Juan | 51.9% | 33.0% | 70.2% | |||
Southeast | 69.8% | 61.4% | 77.0% | |||
Southwest | 65.3% | 58.9% | 71.2% | |||
Summit | 74.9% | 63.2% | 83.8% | |||
Tooele | 69.7% | 60.4% | 77.6% | |||
TriCounty | 57.0% | 48.7% | 64.8% | |||
Utah County | 66.9% | 61.9% | 71.5% | |||
Wasatch | 72.7% | 60.6% | 82.3% | |||
Weber-Morgan | 74.7% | 68.5% | 80.0% | |||
State of Utah | 70.0% | 68.2% | 71.8% |
Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthEducation Level | Percentage of Adults Ages 50-75 | Lower Limit | Upper Limit | |||
---|---|---|---|---|---|---|
Record Count: 5 | ||||||
Less Than High School | 49.8% | 40.3% | 59.4% | |||
H.S. Grad or G.E.D. | 66.7% | 62.8% | 70.4% | |||
Some Post High School | 72.0% | 68.9% | 75.0% | |||
College Graduate | 74.3% | 71.5% | 76.9% | |||
Total | 70.0% | 68.2% | 71.8% |
Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthIncome Category | Percentage of Adults Ages 50-75 | Lower Limit | Upper Limit | |||
---|---|---|---|---|---|---|
Record Count: 5 | ||||||
<$25,000 | 59.8% | 54.0% | 65.4% | |||
$25,000-$49,999 | 65.3% | 60.5% | 69.8% | |||
$50,000-$74,999 | 74.8% | 70.2% | 78.8% | |||
$75,000+ | 74.6% | 71.8% | 77.2% | |||
Total | 70.0% | 68.2% | 71.8% |
Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthMales vs. Females | Age Group | Percentage of Adults 50-75 | Lower Limit | Upper Limit | ||
---|---|---|---|---|---|---|
Record Count: 6 | ||||||
Male | 50-64 | 62.7% | 59.1% | 66.2% | ||
Male | 65-75 | 81.0% | 77.4% | 84.1% | ||
Female | 50-64 | 66.1% | 62.7% | 69.4% | ||
Female | 65-75 | 80.4% | 76.8% | 83.5% | ||
Total | 50-64 | 64.4% | 61.9% | 66.8% | ||
Total | 65-75 | 80.7% | 78.2% | 83.0% |
Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthReferences 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:- Centers for Disease Control and Prevention (CDC) WONDER Database, a system for disseminating public health data and information.
- United States Census Bureau data dashboard.
- Utah healthy Places Index, evidence-based and peer-reviewed tool, supports efforts to prioritize equitable community investments, develop critical programs and policies across the state, and much more.
- County Health Rankings
- Kaiser Family Foundation's StateHealthFacts.org
- Medical literature can be queried at PubMed library.
Page Content Updated On 10/08/2020,
Published on 01/08/2021