Adherence to the USPSTF Colorectal Cancer Screening Recommendation in the United States

Abstract

Timely screening for colorectal cancer (CRC) can reduce CRC-related mortality by detecting the tumor at an early curable stage. The United States Preventive Services Task Force (USPSTF) recommends screening for CRC starting at age 50 and continuing until age 75, with blood stool test performed every one or two years, sigmoidoscopy every five years, and colonoscopy every ten years. The Healthy People 2020 targets 70.5% of Americans to have received CRC screening by 2020, based on the most recent guidelines. This study assessed the prevalence and likelihood of fully meeting the USPSTF recommendation for CRC screening among individuals aged 50 to 75 in the United States. We analyzed the 2018 Behavioral Risk Factor Surveillance System (BRFSS) dataset and utilized the Chi square test and binary logistic regression method. A total of 201,691 individuals were included in the study. The overall prevalence of those who fully met the screening recommendation was 72.1% (N= 145,347). Individuals older than 50-59 years, that were females, of black ethnicity, in a couple relationship, with high school or greater than high school education, earning $25,000 or more annually, and having insurance coverage, were more likely to meet the screening recommendation. Overall, the majority of adults (72.1%) have met the CRC screening recommendation, and have surpassed the goal of the Healthy People 2020, targeting 70.5% of Americans to have received CRC screening by 2020. However, differences persist in the rates of CRC screening based on socio-economic characteristics. More effort to promote screening among disadvantaged groups is warranted.