A26

Objectives: To identify prevalence and compliance trends in colorectal and breast cancer screening among average risk men and women residing in Olmsted County, MN; and to use this data to recommend approaches to improve screening compliance.
 >Methods: Electronic medical record and billing data from the Rochester Epidemiology project were available from 1987-2003 and were used to generate screening compliance data starting in 1997. Eligible women and men were those residing in Olmsted County without diagnoses or procedures indicating that they were at greater than average risk of developing CRC or BC. Men and women age 50+ were evaluated for CRC screening and women age 40+ were evaluated for BC screening. CRC screening exams included colonoscopy, flexible sigmoidoscopy, barium enema, CT colonography or fecal occult blood test. BC screening exams were restricted to mammography. According to ACS screening guidelines, individuals were classified as "Never Screeners," "Ever Screeners," (i.e. undergone screening before, but not current) or "Current Screeners" for each calendar year.
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 >Results: From 1997-2003, the number of screen-eligible women each year ranged from 12,405 to 12,731 for CRC; 19,663 to 21,123 for BC; and 5,409 to 6,292 for both CRC and BC. The number of screen-eligible men ranged from 9,006 to 9,377 annually for CRC. The proportion of women current with BC screening increased steadily over time from 44% to 57%, while the proportion of never screened women steadily declined from 30% to 15%. The percentage of women who had undergone BC screening but were not current with the yearly guidelines was consistent across all 7 years, ranging from 25% to 30%. Median age at first BC screening in this population decreased from age 53 to 49 between 1997 and 2003. For CRC screening, women who were compliant increased steadily from 19% to 42%, while the percentage of never screeners steadily declined from 79% to 54%. The proportion of men compliant with CRC screening also increased steadily from 16% to 37%,. Median age at first CRC screening among men decreased from 61 to 59 years, and among women from 64-59 years. Among women who were current with BC screening, the proportion who were also current with CRC screening steadily increased from 24% to 52% between 1997 and 2003.
 >Conclusions: Our study indicates that compliance with CRC screening and BC screening improved over time. However, both CRC and BC screening rates remain suboptimal. The largest percentage of women classified as "ever" but not "current" screeners for BC suggests that women may not be undergoing annual evaluation. Age at first CRC screening indicates that women and men are initiating this preventive service later than recommended. Interventions designed to decrease rates of differential screening for breast and CRC, improve yearly compliance to BC screening, and lowering age at first screening for both cancers appear warranted.

Sixth AACR International Conference on Frontiers in Cancer Prevention Research-- Dec 5-8, 2007; Philadelphia, PA