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Health Indicator Report of Cancer Screening - Colorectal Cancer Screening

Of cancers that affect both men and women, colorectal cancer is the second leading cause of new cancer cases and cancer deaths in New Mexico. Colorectal cancer screening can significantly reduce colorectal cancer mortality through early detection, when treatment tends to be most effective. Colorectal cancer screening can also actually prevent colorectal cancer by detecting and removing polyps in the colon or rectum that could become cancers in the future.
*Comparable rates for the United States for "current" with colorectal cancer screening recommendations are only available for 2014 and 2016 at this time.

Notes

The colorectal cancer screening questions are only administered in the BRFSS in even-numbered years.   Estimates for 2011 and forward should not be compared to earlier years (please refer to Data Interpretation Issues).

Data Source

Behavioral Risk Factor Surveillance System Survey Data, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, together with New Mexico Department of Health, Injury and Behavioral Epidemiology Bureau.

Data Interpretation Issues

Data for this indicator report are from the Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS), an ongoing survey of adults regarding their health-related behaviors, health conditions, and preventive services. Data are collected in all 50 states, D.C., and U.S. territories. Responses have been weighted to reflect the New Mexico adult population by age, sex, ethnicity, geographic region, marital status, education level, home ownership and type of phone ownership. The survey is conducted using scientific telephone survey methods for landline and cellular phones (with cellular since 2011). The landline phone portion of the survey excludes adults living in group quarters such as college dormitories, nursing homes, military barracks, and prisons. The cellular phone portion of the survey includes adult students living in college dormitories but excludes other group quarters. Beginning with 2011, the BRFSS updated its surveillance methods by adding in calls to cell phones and changing its weighting methods. These changes improve BRFSS' ability to take into account the increasing proportion of U.S. adults using only cellular telephones as well as to adjust survey data to improve the representativeness of the estimates generated from the survey. Results have been adjusted for the probability of selection of the respondent, and have been weighted to the adult population by age, gender, phone type, detailed race/ethnicity, renter/owner, education, marital status, and geographic area. Lastly and importantly, these changes mean that the data from years prior to 2011 are not directly comparable to data from 2011 and beyond. Please see the [https://ibis.health.state.nm.us/view/docs/Query/BRFSS/BRFSS_fact_sheet_Aug2012.pdf BRFSS Method Change Factsheet]. The "missing" and "don't know" responses are removed before calculating a percentage.

Definition

Estimated percentage of New Mexican adults ages 50-75 years who are current with colorectal cancer screening recommendations. An individual is considered current if they have had a take-home fecal immunochemical test (FIT) or high-sensitivity fecal occult blood test (FOBT) within the past year, and/or a flexible sigmoidoscopy within the past 5 years with a take-home FIT/FOBT within the past 3 years, and/or a colonoscopy within the past ten years.

Numerator

Number of New Mexican adults ages 50-75 years from the Behavioral Risk Factor Surveillance System (BRFSS) who reported that they are current with colorectal cancer screening recommendations.

Denominator

Number of New Mexican adults ages 50-75 years from the Behavioral Risk Factor Surveillance System (BRFSS).

Healthy People Objective: C-16, Increase the proportion of adults who receive a colorectal cancer screening based on the most recent guidelines

U.S. Target: 70.5 percent

Other Objectives

New Mexico Cancer Plan 2012-2017 Objectives: By 2017, increase by 15% the proportion of NM men and women ages 50 through 75 who are up-to-date with colorectal cancer screening, from a 2010 baseline of 59.8% to 68.8%.

How Are We Doing?

The percent of New Mexican adults ages 50-75 years who are current for colorectal cancer screening has increased over the past decade.

How Do We Compare With the U.S.?

Comparable rates for current with colorectal cancer screening recommendations are only available for 2014 at this time. In 2014, a lower percentage of New Mexicans reported being current with colorectal cancer screening recommendations compared to the United States overall.

What Is Being Done?

A goal of the New Mexico Department of Health Comprehensive Cancer Control Program is to reduce the burden of colorectal cancer in New Mexico by promoting evidence-based public health initiatives designed to increase the overall rate of New Mexicans ages 50-75 years who are appropriately screened for colorectal cancer.

Evidence-based Practices

The New Mexico Department of Health Comprehensive Cancer Program supports health care providers and health systems across the state in using evidence-based interventions such as patient reminders, risk assessment tools, reducing structural barriers (e.g., expanding clinic hours), provider reminder and recall systems, and provider assessment and feedback on performance. All of these activities have been shown to increase colorectal cancer screening rates, and are recommended by The Guide to Community Preventive Services, a collection of evidence-based findings of the Community Preventive Services Task Force, established by the U.S. Department of Health and Human Services.

Health Program Information

In June 2016, the U.S. Preventive Services Task Force (USPSTF) released its updated recommendation, which continue to recommend screening average risk adults ages 50-75 years for colorectal cancer. The updated recommendation addressed some of the same screening methods endorsed by the previous (2008) USPSTF recommendation, including annual testing with a take-home kit using either a high-sensitivity guaiac-based fecal occult blood test (FOBT) or fecal immunochemical test (FIT), or having a colonoscopy every ten years. The updated recommendation also reviewed evidence for methods of screening not previously endorsed, including flexible sigmoidoscopy every ten years plus annual FIT; CT colonography or flexible sigmoidoscopy every five years; or testing every one or three years with a FIT-DNA test. Of note, the USPSTF found no head-to-head studies demonstrating that any of these screening strategies are more effective than others, although they have varying levels of evidence supporting their effectiveness, as well as different strengths and limitations. Unlike its previous recommendations for colorectal cancer screening, the USPSTF's updated recommendation does not endorse a specific list of screening options. Rather, it notes that the risks and benefits of these screening methods vary considerably in terms of frequency, cost, availability, single-test accuracy, convenience, and potential serious complication - leaving it up to clinicians and patients to use this information to choose a screening method. A modeling study included in the updated 2016 U.S. Preventive Services Task Force recommendations predicted that using any one of the following four screening strategies will have a comparable balance of life-years gained, potential harmful complications, and screening burden, assuming 100% adherence: annual FIT; flexible sigmoidoscopy every ten years plus annual FIT; CT colonography every five years, or colonoscopy every ten years. Before 2010, the BRFSS did not differentiate between sigmoidoscopy and colonoscopy when asking respondents about colorectal cancer screening. Therefore, in 2002-2008 an individual was considered current with colorectal cancer screening recommendations if they had either a take-home FIT or high-sensitivity FOBT within the past year, and/or a flexible sigmoidoscopy within the past 5 years with a take-home FIT or high-sensitivity FOBT within the past 3 years, and/or a colonoscopy within the past 10 years.
Page Content Updated On 08/21/2017, Published on 10/31/2017
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Content updated: Tue, 31 Oct 2017 13:04:37 MDT