The American Cancer Society estimates that approximately 142,820 new colorectal cancer cases are expected to occur in the United States in 2013, with a total of 50,830 estimated deaths expected to occur. Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death among both men and women in the United States. Colorectal cancer can be prevented by early detection and colorectal cancer screening has been shown to be effective. Screening reduces mortality both by decreasing incidence and by detecting cancers at more treatable stages of disease. Despite this, colorectal cancer screening is underutilized, with only about half of people age 50 or older reporting having had colorectal cancer testing that is consistent with current screening guidelines from the American Cancer Society. Low rates of colorectal cancer screening are especially problematic among underserved populations, including rural and racial/ethnic minority populations. In particular, National Health Interview Survey data shows that Hispanics age 50 and older reported having had either a fecal occult blood test (FOBT) within the past year or sigmoidoscopy or colonoscopy within 10 years less frequently (45%) compared to non-Hispanic Whites (59%). The purpose of this study was to quantify and compare recent national surveillance data on colorectal cancer screening uptake among rural, urban, and suburban populations in the United States. Rates of FOBT and colonoscopy were estimated for these populations. Data utilized in this study included Behavioral Risk Factor Surveillance System (BRFSS) data from 2008 and 2010. A total of n=557,553 subjects that were 50 years of age and older participated in the BRFSS surveys over this time period. Subjects were coded into rural, urban, and suburban residence by using metropolitan statistical area codes. In comparison between Hispanic, American Indian, and non-Hispanic White populations, we found that rural Hispanic populations had the lowest percentage that reported a FOBT within the past year (10%; 95% CI=8.1%-12.3%) and suburban American Indian populations had the highest percentage (16%; 95% CI=12.8%-20.6%). Rural Hispanic populations also had the lowest percentage that reported a colonoscopy within the past 10 years (35%; 95% CI=32.2%-38.3%) and urban non-Hispanic White populations had the highest percentage (60%; 95% CI=59.1%-60.2%). Overall, the population with the highest percentage that was up-to-date with colorectal cancer screening was urban-dwelling non-Hispanic Whites (65%; 95% CI=64.8-65.8). In addition, 24% (95% CI=23.1%-25.4%) of rural populations that did not have a personal doctor reported having had a colonoscopy within the past 10 years, compared to 56% (95% CI=55.3%-56.1%) of rural populations, 60% (95% CI=59.9%-60.8%) of suburban populations and 60% (95% CI=59.6%-60.5%) of urban populations that had a personal doctor reporting a colonoscopy within the past 10 years. These results provide evidence that there continues to exist a great need to increase colorectal cancer screening uptake, especially among rural and underserved minority populations.

Citation Format: Tomas Nuno, Ivo Abraham. Colorectal cancer screening utilization among rural and minority populations in the United States. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr C07.

©2013 American Association for Cancer Research.
2013