CDC: Too few people being screened for colorectal cancer

Stephen Feller

CDC researchers found there is enough capacity in the healthcare system for 80 percent of targeted groups of people to be screened for colorectal cancer -- a goal set in 2014 by the agency; however, people generally are not up-to-date with either a colonoscopy, pictured, or a blood test for the disease. Photo by Robert Przybysz/Shutterstock

Although the U.S. Centers for Disease Control set a goal for 80 percent of people in at-risk groups to be screened for colorectal cancer by 2018, they had not considered until a recent study whether there was capacity in the healthcare system for it to happen.

A new report from the CDC shows the goal is possible, with some older parts of the population approaching an 80 percent screening rate but more work still left to be done.

Colorectal cancer -- a combined reference to cancers of the colon and rectum -- is the second leader cancer killer in the United States, causing more than 130,000 diagnoses and more than 50,000 deaths per year, according to CDC statistics.

Screening, recommended for all adults between the age of 50 and 75, is used to find precancerous polyps, or abnormal growths in the colon or rectum, so they can be removed before they turn into cancer, or to catch cancer at as early a stage as possible, CDC researchers said in a press release.
For the study, published in the journal Cancer, CDC researchers used a mathematical model to simulate screening test use between 2014 and 2040, using either colonoscopy or fecal immunochemical testing methods.

Had the CDC started a national screening program in 2014, when the agency launched the program to get to 80 percent screening, the researchers estimate about 47 million FIT procedures and 5.1 million colonoscopies would be needed for a FIT-based program. If colonoscopy were the main screening method, about 11 to 13 million would need to be conducted.

The study estimated that roughly 15 million colonoscopies were performed in 2012, and that 10.5 million more could be -- which the researchers are confident could cover the actual number of procedures needed to screen 80 percent of older adults in the country.

Although the number of screenings per year has lagged in some age groups, a recent study conducted by the National Institutes of Health found about 72 percent of all individuals between age 69 and 89 were up-to-date, and of those receiving FIT tests, 65 percent had a follow-up colonoscopy within three months.

The NIH researchers note, however, that considerable numbers of patients were not up to date on screening or did not have a follow-up in a reasonable amount of time, much like CDC researchers in the study on screening capacity estimates that just half the population targeted for screening is up to date.

"There are many opportunities for improvement in screening completion among the elderly," NIH researchers said in a press release. "Primary care practices need to develop and integrate systems to support individualized as opposed to age-based decision making, including risk assessment tools that consider age and comorbidity in estimates of benefits and harms."