The NYS Cancer Consortium’s Colorectal Cancer Action Team acknowledges March as Colorectal Cancer Awareness Month. Each year in New York State, approximately 9,000 people develop colorectal cancer, and 3,000 New Yorkers die from it. One out of every 24 adults will develop colorectal cancer sometime in their life. Colorectal cancer occurs most often as people age (60% of new cases occur among those age 65 and older), however nearly 94% of all colorectal cancers are diagnosed after age 45.
Average Risk Colorectal Cancer Screening Starts at Age 45: Regular screening for colorectal cancer can save lives. For adults at average risk for colorectal cancer, the United States Preventive Services Task Force and the American Cancer Society now recommend that screening for colorectal cancer begin at age 45. The change to start average risk screening at age 45 comes as national and New York State data show that 9 out of 10 new colorectal cancer cases happen in adults aged 45 and older. There are a number of tests to screen for colorectal cancer. The three main tests—colonoscopy, the stool blood test (which also includes the fecal immunochemical test), and flexible sigmoidoscopy—are all effective at finding problems before they become cancer, or they can find cancer early.
The Importance of Recommending Screening: Colorectal cancer may not always cause symptoms, which is why screening for colorectal cancer is so important. A clinician’s recommendation for colorectal cancer screening is a significant motivator to a patient completing a cancer screening. In NYS, however, many adults report they are not getting this recommendation from their health care professional.
Colorectal Cancer Screening Rates are Lowest Among Younger Adults: Colorectal cancer screening rates are lowest among adults 50 to 54 years old compared to older adults (statewide rates for those ages 45-49 are not yet available). Among younger adults, screening rates are lowest for men, those with lower household incomes, those without health insurance and those who report not having a personal health care provider. (See this 2021 Information for Action sheet).
Blue = Report being screened / Yellow = Report being unscreened
It’s Safe To Return for Cancer Screening: The COVID-19 pandemic impacted many preventive health efforts, including colorectal cancer screening. Health care providers have taken steps so that important health visits can happen safely including offering socially distanced waiting rooms and more time added between appointments. For patients who are hesitant to come into a practice, evidence-based stool tests that are done at home and mailed to a lab are a safe and effective choice; a colonoscopy is then needed only if the stool-based test is abnormal.
Talk about Risk Factors, Symptoms and Screening with Adult Patients of Any Age: An estimated 30% of people are at higher risk for colorectal cancer due to family history or because they have other bowel diseases like Crohn’s or ulcerative colitis. These higher risk adults should begin colorectal cancer screening before age 45. Also, anyone of any age who has symptoms of colorectal cancer such as blood in the stool or tar-like stools, stomach pain or cramps that do not go away, change in bowel movement habits – either constipation or diarrhea, or losing weight without trying, should not wait and should be tested for colorectal cancer.
Calls to Action:
- For Adults – Speak with your provider about getting screened and ask about screening test options.
- For Providers
- Talk to your patients about colorectal cancer screening before age 45 to prepare them to start screening on time.
- Discuss screening with adult patients at every encounter and not just at yearly check-ups.
- Review family history, risk status, symptoms and screening test options at an early age to identify if someone needs to be tested for colorectal cancer earlier than age 45.
- Use evidence-based interventions across your health network.
- Strengthen the messages for use by all members of the clinic team to encourage screening.
- Create customizable patient health information for specific patient populations in your network.
- Barriers of colorectal cancer screening in rural USA: a systematic review
- Colorectal Cancer: Catch It Early and Reduce Your Risk (ACS, 2021)
- Colorectal Cancer NYSDOH main page
- Colorectal Cancer Screening: Which Test is Right for You? (ACS, 2018)
- CDC Resources to Share (Videos, Radio scripts, Social Media Posts)
- Insurance: Screening for colorectal cancer is a covered benefit through Medicaid as well as health plans participating in the New York State of Health. The New York State Cancer Services Program offers no-cost colorectal cancer screening to eligible people who do not have insurance in every NYS county. Call 1-866-442-CANCER (2262) for help connecting to the Cancer Services Program in your area.
This newsletter article was written by the NYS Cancer Consortium Colorectal Cancer Action Team. The Consortium welcomes new members. Join the NYS Cancer Consortium to stay abreast of NYS-focused cancer prevention and control efforts, and for ways to get involved. Membership is free. https://www.nyscancerconsortium.org/secure/register.cfm